Isolated infective endocarditis in the native pulmonary valve is an unusual clinical entity in patients without predisposing factors and in non-intravenous drugs users. We present the case of a 75-year-old patient, with a subacute clinical picture of fever and pulmonary cavity nodules, admitted to our hospital with an initial suspected diagnosis of pulmonary tuberculosis. The presence of Enterococcal bacteremia in hemocultive and the documentation of a large vegetation in pulmonary valve by transtoracic and transesophageal echocardiography were key factors for final diagnosis.