Pneumococcal aortic valve endocarditis causing aortopulmonary artery fistula

We report a case of an aortic-pulmonary artery fistula secondary to acute bacterial endocarditis and aortic root abscess formation. The patient presented with generalized symptoms and an initial pneumococcal pneumonia, then developed respiratory and cardiac failure necessitating ventilation and inotropic agents. An echocardiogram showed a vegetation in the aortic valve, an abscess involving the aortic root, and suggested a fistula between the aorta and main pulmonary artery, which was confirmed at emergent operation. Despite a complicated early postoperative course the patient has made a full recovery.