ArticleIDCases2026
When echocardiography fails: Fatal
Article in IDCases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: 22q11.2 Deletion Syndrome (DiGeorge Syndrome) confers a high risk for infective endocarditis (IE) due to coexisting conotruncal heart defects, prosthetic material, and immune deficiency. Diagnosing IE on a right ventricle-to-pulmonary artery (RV-PA) conduit can be challenging. Case summary: A 31-year-old female with 22q11.2 deletion syndrome and repaired pulmonary atresia with a ventricular septal defect (RV-PA conduit) presented with febrile syndrome two months after pacemaker implantation. Initial transesophageal echocardiography (TEE) was negative. She was treated for a pacemaker lead infection with lead extraction and antibiotics, with initial improvement. She relapsed shortly after completion of therapy.The second TEE was not diagnostic. A definitive diagnosis was only achieved by 18F-FDG PET/CT, which demonstrated intense uptake at the conduit and a septic embolism in the fourth dorsal vertebra. Despite emergency surgery, the conduit was found to be destroyed by a fistulizing pseudoaneurysm, and the patient died due to uncontrollable hemorrhage. Conclusion: This fatal case highlights the critical limitations of echocardiography in diagnosing prosthetic conduit endocarditis. 18F-FDG PET/CT was the pivotal diagnostic modality, confirming the infection after all other methods failed. This underscores the necessity of integrating advanced molecular imaging early in the diagnostic algorithm for such high-risk patients to enable timely intervention and prevent catastrophic outcomes.
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