Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, 9308Padua University Hospital, Padua, Italy.
Pediatric Cardiac Surgery Unit, 89685Cedimat Cardiovascular Center, Santo Domingo, Dominican Republic.
World J Pediatr Congenit Heart Surg. 2020 Sep;11(5):654-657. doi: 10.1177/2150135120929009.
Although infective endocarditis rarely appears during infancy, fungal infections remain a concern in the preterm neonatal population as the result of compromised immunity, prolonged hospitalization, and invasive procedures. The increased awareness of fungal colonization and improvements in medical therapy have not reduced the high mortality rate of mycotic infections in premature newborns, especially in developing countries, and there is no consensus on the surgical timing to treat neonatal fungal endocarditis. We present the case of a two-month-old boy with a history of three weeks of hospitalization for prematurity. After being discharged, the patient developed symptomatic candidemia resulting from a large right atrial abscess obstructing the tricuspid valve; despite antifungal therapy, urgent surgical resection was required.
虽然感染性心内膜炎在婴儿期很少见,但由于免疫功能受损、住院时间延长和有创操作,真菌感染仍然是早产儿人群关注的问题。由于对真菌定植的认识提高以及医学治疗的改善,真菌性感染在早产儿中的高死亡率并未降低,尤其是在发展中国家,而且对于治疗新生儿真菌性心内膜炎的手术时机也没有共识。我们报告了一例两个月大的男孩,他因早产住院了三个星期。出院后,该患者出现了症状性念珠菌血症,原因是一个大的右心房脓肿阻塞了三尖瓣;尽管进行了抗真菌治疗,但仍需要紧急手术切除。