Untreated Tetralogy of Fallot in an Adult Patient Complicated by Acute Pulmonary Valve Endocarditis

We report the case of a 18 years old male, who presented to the emergency department for prolonged fever, weight loss, with a systolic murmur, echocardiography showed a tetralogy of fallot with multiple vegetations on the pulmonary ejection pathway and pericardial effusion. The diagnosis of certain endocarditis was retained with one major Duke criterion (image of vegetation on the pulmonary pathway) and 3 minor Duke criteria (fever at 39°C, glomerulonephritis and predisposing congenital heart disease). All blood cultures were negative and PCR for mycobacterium tuberculosis was positive in the pericardial liquid. The patient was treated by intravenous antibiotics associating Ceftriaxone and Gentamycin associated to anti-tuberculosis treatment according to the Moroccan national protocol with good evolution.