Isolated right-sided mural infective endocarditis in a 32-year-old woman with muscular ventricular septal defect

Bacterial endocarditis secondary to jet streams from a congenital heart defect without valvular involvement is very rare, especially in adult patients. We report an unusual case of a 32-year-old woman with a previously known unrepaired ventricular septal defect (VSD) who presented with intermittent fever and chills after dental treatment and was diagnosed with isolated right-sided mural infective endocarditis associated with a muscular-type VSD. Echocardiography revealed a low echogenic, mobile vegetation along the right ventricular outflow tract (RVOT) free wall and a small-sized muscular-type VSD. The patient's blood culture grew Streptococcus viridians. After 3 weeks of antibiotic treatment, VSD patch closure was performed, and the vegetation on the RVOT endomyocardium was removed.