Tri-Valvular Endocarditis in a Previously Normal Heart Misdiagnosed as Recurrent Valley Fever

Abstract

Infective endocarditis (IE) is classified as an infection of any cardiac valve or endocardial surface. This condition is associated with high morbidity and mortality; hence, early diagnosis and rapid intervention are extremely vital. Although IE is frequently found to infect only one heart valve, rare instances have shown multi-valvular involvement. Many conditions can present similar to IE, often delaying the diagnosis of IE. Coccidioidomycosis (or Valley Fever), a fungal infection endemic in the Southwestern United States, can present with features analogous to those of IE. We present the case of a middle-aged male with no underlying structural heart disease found to have tri-valvular IE after being misdiagnosed with recurrent Valley Fever.

Keywords: coccidioidomycosis; infective endocarditis; modified dukes criteria; multiple valves; septic emboli; streptococcus viridans; transthoracic echocardiogram.