Unsuspected rheumatic heart underlying group B streptococcal endocarditis at the age of 20 months.
The case is reported of a 20-month-old girl admitted to our centre for group B streptococcal endocarditis who died of complete atrioventricular block after a week of treatment. There was no history pointing to the presence of a heart disorder. Necropsy disclosed the surprising existence of a vast rheumatic carditis involving essentially the aortic and mitral valves, with bacterial superinfection of the former. The double rheumatic and infectious lesion in such a young patient with infective pseudo-aneurysms of the sinuses of Valsalva makes this an exceptional case.
Moral
L
L
Servicio de Pediatría, Hospital Materno-Infantil Valle de Hebrón, Barcelona, Spain.
Majó
J
J
Rubio
E M
EM
Ruiz
C
C
Casaldáliga
J
J
D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000473:pathology*; D004697:Endocarditis, Bacterial / Q000150:complications / Q000473:pathology*; D005260:Female; D006327:Heart Block / Q000209:etiology; D006801:Humans; D007223:Infant; D012214:Rheumatic Heart Disease / Q000150:complications / Q000473:pathology*; D012850:Sinus of Valsalva; D013290:Streptococcal Infections / Q000150:complications / Q000473:pathology*; D013292:Streptococcus agalactiae