Pediatric Tricuspid Valve Infective Endocarditis- Insite into a challenging management

:Pediatric tricuspid vavle endocarditis is an uncommon entity which is now becoming prevalent oweing to improved diagnostic methods and increase number of cardiac surgeries.Paediatric right sided infective endocarditis are mostly secondary to structural heart defects or indwelling venous catheters .We present a case of paeditric tricuspid valve endocarditis presenting with complete heart block,septic arthritis, pulmonary abcess with no structural heart defect diagnosted preoperatively.Intra-operatively a ventricular septal defect was diagnosed and managed .We present the difficult management of the case by medical and surgical intervention and management of secondary fungal infective endocarditis with repeated successful surgical intervention . We also emphasize on lack of established guidelines for management of right -sided infective endocarditis.