Infective Endocarditis Caused by Methicillin-Resistant Staphylococcus aureus Combined with Meningitis.
10.14776/piv.2016.23.3.229
- Author:
Kyung Won NA
1
;
Jon Soo KIM
;
Hyun Jung KIM
Author Information
1. Department of Pediatrics, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea. sara67770@eulji.ac.kr
- Publication Type:Case Report
- Keywords:
Endocarditis;
Methicillin-resistant Staphylococcus aureus;
Meningitis;
Antibiotic prophylaxis
- MeSH:
Anti-Bacterial Agents;
Antibiotic Prophylaxis;
Cerebrospinal Fluid;
Child;
Diagnosis;
Endocarditis*;
Follow-Up Studies;
Hospitalization;
Humans;
Leukocytosis;
Meningitis*;
Meningitis, Bacterial;
Methicillin Resistance*;
Methicillin-Resistant Staphylococcus aureus*;
Mitral Valve;
Mitral Valve Prolapse;
Recurrence;
Risk Factors
- From:Pediatric Infection & Vaccine
2016;23(3):229-235
- CountryRepublic of Korea
- Language:English
-
Abstract:
Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide concern. We present a case of a 12-year-old child with IE of the native mitral valve due to MRSA infection after an invasive dental procedure. Based on the clinical symptoms and the presence of cerebrospinal fluid pleocytosis, the patient was initially diagnosed with presumed bacterial meningitis and treated with empiric antibiotics. On the third day of hospitalization, MRSA was cultured from the initial blood samples and vegetation was observed on the mitral valve during an echocardiogram, findings which are compatible with a diagnosis of IE. The revised guidelines for antibiotic prophylaxis for the prevention of IE advise that IE prophylaxis for dental procedures is reasonable only for patients with underlying cardiac conditions, who are at the highest risk of adverse outcomes from IE. However, in this case, the patient had no high risk factors indicative of IE prophylaxis, except for mitral valve prolapse. She had no recurrence of IE over a follow-up period of 12 months.
