Infective endocarditis (IE) refers to infection
of cardiovascular structures. Despite recent advances
in diagnosis and management of IE, patients
with IE still have high morbidity and mortality
rates.1 Rheumatic heart-valve disease (RHD)
is one of the most common underlying condition
predisposing to endocarditis, especially in developing
countries.2 Patent ductus arteriosus (PDA),
even if small, is also associated with a high risk
of infective endarteritis (IEa) relative to the normal
heart.3–5 IE is rarely seen in pregnancy and
puerperal period. It generally occurs in patients
with pre-existing heart disease or intravenous (IV)
drug abuse, and is associated with very high rates
of maternal and fetal loss. In this report, we describe
a case of a patient with missed diagnosis
of RHD and a moderate size PDA, in whom multisite
IE/IEa developed after uncomplicated vaginal
delivery