Al-Senaidi Khalfan S, Abdelmogheth Anas-Alwogud A, Balkhair Abdullah A
Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Sultan Qaboos Univ Med J. 2014 Feb;14(1):e130-3. Epub 2014 Jan 27.
Infective endocarditis (IE) is an uncommon but life-threatening infection. Despite advances in management, it still causes high morbidity and mortality. We report the case of an 8-year-old girl who presented with a prolonged fever of 2.5 months duration and a history of a small perimembranous ventricular septal defect. She was diagnosed with subacute bacterial endocarditis secondary to Streptococcus mutans. The patient developed a septic pulmonary embolism; however, with the use of appropriate antimicrobial therapy, she made an uneventful recovery. Clinicians should have a high index of suspicion for IE as the possible cause of a prolonged fever, especially in the presence of congenital heart disease (CHD). Currently, IE prophylaxis is not indicated for unrepaired acyanotic CHD. Nevertheless, with the new changes in the guidelines, more prospective studies are needed to investigate the incidence of IE in such lesions, before long-term conclusions can be drawn.
感染性心内膜炎（IE）是一种罕见但危及生命的感染。尽管在治疗方面取得了进展，但它仍然导致高发病率和死亡率。我们报告了一名8岁女孩的病例，她出现了持续2.5个月的长期发热，并有小型膜周部室间隔缺损病史。她被诊断为继发于变形链球菌的亚急性细菌性心内膜炎。该患者发生了脓毒性肺栓塞；然而，通过使用适当的抗菌治疗，她顺利康复。临床医生对于IE作为长期发热可能原因应保持高度怀疑指数，尤其是在存在先天性心脏病（CHD）的情况下。目前，对于未修复的非青紫型CHD不建议进行IE预防。然而，随着指南的新变化，在得出长期结论之前，需要更多前瞻性研究来调查此类病变中IE的发生率。
