[Pneumococcal endocarditis in a previously healthy 17-month-old boy].

Abstract

Invasive pneumococcal infection is a severe disease and its incidence may be increasing. Endocarditis due to Streptococcus pneumoniae is uncommon, particularly in children without risk factors. Etiologic diagnosis is difficult when cultures are negative. We report the case of a previously healthy, 17-month-old boy not vaccinated against pneumococcus who, during the course of pneumonia treated with beta-lactam antibiotics, developed cardiorespiratory deterioration and heart murmur. Mitral valve vegetation was identified by transthoracic echocardiography. Endocarditis was diagnosed and new antibiotics were given for 6 weeks (cefotaxime, gentamycin and vancomycin). Cultures were negative. Because of lack of improvement, prosthetic mitral replacement was indicated. S. pneumoniae was identified by polymerase chain reaction (PCR) in the pathological specimen. Outcome was favorable, and the patient remained symptom-free after 6 months of follow-up. The possibility of endocarditis as an invasive pneumococcal infection should be considered in children without risk factors. PCR is a useful technique to establish the etiology when cultures are negative.

• Authors: M Murillo Vallés, S Cañadas Palazón, P Domínguez Sampedro, P Soler Palacín, C Bonjoch Marí, J Roqueta Mas
• Journal: Anales de pediatria (Barcelona, Spain : 2003) (An Pediatr (Barc)) Vol. 66 Issue 6 Pg. 615-8 (Jun 2007) ISSN: 1695-4033 [Print] Spain
• Vernacular Title: Endocarditis neumocócica en niño de 17 meses previamente sano.
• PMID: 17583625 (Publication Type: Case Reports, Journal Article)

Topics

• Endocarditis, Bacterial (diagnosis, surgery)
• Heart Valve Prosthesis
• Humans
• Infant
• Male
• Mitral Valve
• Mitral Valve Insufficiency (diagnostic imaging, microbiology, surgery)
• Pneumococcal Infections (diagnosis)
• Polymerase Chain Reaction
• Streptococcus pneumoniae (isolation & purification)
• Ultrasonography