Bacterial pancarditis with myocardial abscess: successful surgical intervention in a 14-month-old boy

Tex Heart Inst J. 2015 Feb 1;42(1):55-7. doi: 10.14503/THIJ-13-3685. eCollection 2015 Feb.

Abstract

A 14-month-old boy with a structurally normal heart presented with signs of cardiac tamponade caused by purulent pericarditis. During his hospital stay, mitral and tricuspid valve endocarditis developed, and a ventricular septal abscess expanded despite appropriate, prolonged antibiotic therapy for methicillin-resistant Staphylococcus aureus. The day before scheduled surgical correction, the abscess ruptured, creating a septal aneurysm. Surgical intervention resulted in an excellent outcome. Throughout the patient's 67-day hospitalization, the use of echocardiography was crucial in monitoring and diagnosis. In addition to reporting this case, we discuss our diagnostic and treatment considerations. To our knowledge, this is only the 4th report of S. aureus bacterial pancarditis with myocardial abscess.

Keywords: Bacterial infections/diagnosis/therapy; child, preschool; echocardiography; endocarditis, bacterial/complications/drug therapy; heart aneurysm/diagnosis/etiology; pericarditis/diagnosis/therapy; staphylococcal infections/complications/drug therapy/surgery; treatment outcome.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis
  • Abscess / microbiology
  • Abscess / surgery*
  • Anti-Bacterial Agents / therapeutic use
  • Cardiac Surgical Procedures*
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / surgery*
  • Heart Aneurysm / microbiology
  • Heart Aneurysm / surgery
  • Humans
  • Infant
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / microbiology
  • Mitral Valve / surgery*
  • Pericarditis / diagnosis
  • Pericarditis / microbiology
  • Pericarditis / surgery*
  • Predictive Value of Tests
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / surgery*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tricuspid Valve / diagnostic imaging
  • Tricuspid Valve / microbiology
  • Tricuspid Valve / surgery*
  • Ultrasonography
  • Ventricular Septum / diagnostic imaging
  • Ventricular Septum / microbiology
  • Ventricular Septum / surgery*

Substances

  • Anti-Bacterial Agents