We report a 47-year-old man who presented with right-sided heart failure. Transthoracic echocardiography revealed a tunnel-shaped communication (ventricular septal defect) between the left ventricle and the right ventricle with a significant left-to-right shunt. The VSD is connected to the lateral wall of the right ventricle by a large tunnel.

Congenital heart disease is a risk factor for infective endocarditis. Ventricular septal defects and ventricular outflow tract obstructions are the most common causes of endocarditis in this population. We presented a patient diagnosed with leukocytoclastic vasculitis with renal and pulmonary involvement with right-sided infective endocarditis as an etiology for vasculitis.