DOI: https://doi.org/10.36347/sjmcr.2025.v13i09.056

Pages: 2174-2177

Background: Laubry–Pezzi syndrome perimembranous ventricular septal defect (VSD) complicated by aortic cusp prolapse and aortic regurgitation (AR) creates high-velocity jets that injure aortic leaflets and may predispose to infective endocarditis (IE). Case: A 28-year-old woman with poor dental status presented with acute decompensated heart failure (NYHA IV dyspnea, orthopnea, bibasal crackles, ankle edema) and a high-pitched diastolic murmur with accentuated P2. She was afebrile but had inflammatory anemia and elevated inflammatory markers. Blood cultures yielded Staphylococcus hominis. Transthoracic echocardiography identified a restrictive perimembranous VSD (4 × 2 mm) on the aortic surface of the right anterior cusp findings consistent with Laubry–Pezzi syndrome complicated by IE. Whole-body CT showed homogeneous hepatomegaly without embolic foci. Targeted antimicrobial therapy was initiated (ceftriaxone 2 g/day for 4 weeks plus gentamicin 4 mg/kg once daily for 2 weeks). Management and outcome: After clinical stabilization, a heart-team strategy was planned for surgical closure of the VSD with concomitant aortic valve repair (preferred in young patients) or replacement if repair proved unfeasible, aiming to control infection, treat severe AR, and prevent recurrence. Conclusion: In adults with perimembranous VSD and new or worsening AR, Laubry–Pezzi syndrome should be suspected and actively searched for on echocardiography. Poor oral health warrants a low threshold for IE work-up. Early multidisciplinary referral for combined surgical correction is essential to limit valve damage and reduce the risk of recurrent IE.