Florencia Escarrá1, Ana G Fedullo1, Natalia Veliz2, Julián Rosa2, Rodrigo Oribe3, Marisa Di Santo3, Bqca Vanesa Reijtman4, Lic Alejandra Mastroianni4, Guadalupe Pérez1. 1. Servicio de Control Epidemiológico e Infectología, Hospital de Pediatría "Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina. 2. Servicio de Clínica Pediátrica, Hospital de Pediatría "Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina. 3. Servicio de Cardiología, Hospital de Pediatría "Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina. 4. Servicio de Microbiología, Hospital de Pediatría "Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
Abstract
INTRODUCTION: the incidence of invasive infections caused by pneumococcus (Streptococcus pneumoniae) has declined since generalized vaccination with pneumococcal conjugated vaccine, but it is still a prevalent pathogen in children. Amongst pneumococcal invasive infections, IE (infectious endocarditis) is rare, with an incidence between 1 and 7%. CASE REPORT: We describe the case of a previously healthy 4 year old boy, who had received one dose of 10-valent pneumococcal conjugate vaccine who presents with fever, a new heart murmur and heart failure. Blood cultures were posi tive for penicillin susceptible pneumococcus. The transthoracic echocardiogram showed tricuspid and pulmonary valve vegetations. The patient received 4 weeks of antibiotic treatment for pneumo-coccal IE. He presented secondary valve damage that needed surgical treatment. CONCLUSIONS: IE should be considered as a differential diagnosis of children presenting with fever and a newly diag nosed heart murmur, and pneumococcus as an etiologic agent in non hospitalized febrile patients with severe infections.
INTRODUCTION: the incidence of invasive infections caused by pneumococcus (Streptococcus pneumoniae) has declined since generalized vaccination with pneumococcal conjugated vaccine, but it is still a prevalent pathogen in children. Amongst pneumococcal invasive infections, IE (infectious endocarditis) is rare, with an incidence between 1 and 7%. CASE REPORT: We describe the case of a previously healthy 4 year old boy, who had received one dose of 10-valent pneumococcal conjugate vaccine who presents with fever, a new heart murmur and heart failure. Blood cultures were posi tive for penicillin susceptible pneumococcus. The transthoracic echocardiogram showed tricuspid and pulmonary valve vegetations. The patient received 4 weeks of antibiotic treatment for pneumo-coccal IE. He presented secondary valve damage that needed surgical treatment. CONCLUSIONS: IE should be considered as a differential diagnosis of children presenting with fever and a newly diag nosed heart murmur, and pneumococcus as an etiologic agent in non hospitalized febrile patients with severe infections.