A case of fatal infective endocarditis in uncorrected tetralogy of Fallot with persistent left superior vena cava

Infectious endocarditis is characterized by the inflammation of the endocardium, and individuals with congenital heart disease (CHD) are at a higher risk for developing infective endocarditis (IE), with a predicted risk 100 times that of the general population. We present a rare case of fatal infectious endocarditis in a 39-year-old female with uncorrected Tetralogy of Fallot (TOF) with persistent left superior vena cava (PLSVC). Recurrent dental infections and multiple skin infections may have contributed to the development of IE, and the patient's prolonged survival without surgical intervention is unusual. The examination of the heart revealed features of TOF with PLSVC, along with vegetations on the tricuspid valve. The patient developed both cardiac and extra-cardiac complications due to the development of septic emboli, leading to abscess formation in the lungs, kidneys, and spleen. The microbiological examination showed the typical organism, Enterococcus faecalis, in accordance with Duke's criteria. This case underscores the complex association between CHD and IE, with unique gross autopsy and histopathological and microbiological findings that are rarely observed in prolonged cases of dual cardiac anomalies.