[MYCOTIC ANEURYSM OF THE ASCENDING AORTA AND CEREBRAL INFARCTS IN A 17-MONTH OLD CHILD WITH KINGELLA KINGAE ENDOCARDITIS].
Endocarditis is an uncommon presentation of Kingella kingae infection in children. A previously healthy 17 month old child was referred to our emergency department for evaluation of fever lasting eleven days, aphthous stomatitis and a new systolic murmur. Within a few hours of admission, antibiotic therapy was initiated for a presumptive diagnosis of bacteremia and within 24 hours after admission, gram negative coccobacilli were growing in the blood culture. In addition, echocardiography demonstrated a mycotic aneurysm of the ascending aorta with a mobile vegetation. The presumptive diagnosis of Kingella kingae endocarditis was made. Further evaluation by MRI revealed frontal and occipital cerebral infarcts. Due to the presence of presumed septic emboli in conjunction with progressive left ventricular dysfunction, the child was urgently taken to the operating room where aggressive debridement of the infected tissue was performed and the aortic aneurysm was repaired. The patient had an uneventful post-operative course. This case emphasizes the need for a high index of suspicion when evaluating children with community acquired infection. In addition, it also demonstrates the importance of early diagnosis and appropriate treatment of K. kingae endocarditis.
Liat Feraru
LF
Feldman
Ziv
Z
Hersh
Einat
E
Birk
Gabi
G
Amir
George
G
Wertheimer
D000785:Aneurysm, Infected / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology; D016470:Bacteremia / Q000175:diagnosis; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology; D004452:Echocardiography; D004696:Endocarditis / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D017882:Kingella kingae / Q000302:isolation & purification; D008279:Magnetic Resonance Imaging; D008297:Male; D016870:Neisseriaceae Infections / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology