Concurrent Tricuspid Valve Endocarditis and Stroke Following Lung Transplantation: A Case Report

Abstract

Introduction: Infective endocarditis (IE) is a relatively rare complication among solid organ transplant recipients, including those who have undergone lung transplantation (LTx). Cerebrovascular complications, such as stroke, may also occur after LTx. Case Presentation: We report a case of tricuspid valve infective endocarditis (TVIE) accompanied by a stroke in a 46-year-old man approximately 10 days after unilateral LTx. The patient presented with neurological deficits, tachycardia, and marked leukocytosis. Diagnostic evaluation confirmed TVIE and stroke; however, transthoracic echocardiography revealed no intracardiac structural defects. Intravenous antibiotics and antithrombotic therapy resulted in clinical stabilization and improvement in both cardiac and neurological conditions. Conclusions: Right-sided IE should be suspected in early post-LTx patients who develop systemic inflammation with new focal neurological deficits, even when imaging does not identify a septal defect. This case is notable because stroke and right-sided IE occurred concurrently after LTx without an identifiable intracardiac shunt, making a direct embolic relationship between right-sided IE and stroke uncertain. The patient’s favorable outcome, despite severe post-transplant infectious and cerebrovascular complications, highlights the importance of prompt diagnosis, pathogen-directed therapy, and multidisciplinary management.