A young man with chest pain and fever.

A young man with an unremarkable medical history was diagnosed with meningococcal endocarditis and was treated with penicillin and gentamycin. Further history was complicated by a fistulisation between the left ventricle and right atrium and aortic and tricuspid valve insufficiency. Aortic valve replacement, correction of the fistulisation and annuloplasty of the tricuspid valve were performed with good results. A search of the literature revealed only ten cases of meningococcal endocarditis without any report concerning the tricuspid valve.