: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.

A 32 yr female was referred for surgery for Left atrial myxoma based on symptoms of dyspnea on exertion , palpitations and echocardiography revealing a left atrial mass , mostly likely a left atrial myxoma. On chest X ray , there was right lower lobe white out which instigated the need to perform a CT chest. On CT Chest a 10.9x14.2x13.6 cm (APxTRxCC) cm heterogenously hypodense mass was seen along the posterior and inferior aspect of right hemithorax. It showed multiple vascular channels within it and broad base towards posterior pleura. It had ill defined planes with left atrium and extension into the left atrium through right inferior pulmonary vein. It was causing compression of right descending pulmonary artery and right lower lobe bronchus with collapse of right lower lobe. Likey etiology was sarcomatous/malignant vascular mass. Patient was transferred to oncology department for further management