Department of Cardiovascular Surgery, Mt. Fuji Shizuoka Children's Hospital, Urushiyama 860, Aoi-ku, Shizuoka city, Shizuoka, 420-8660, Japan.
Gen Thorac Cardiovasc Surg. 2021 Jun;69(6):993-995. doi: 10.1007/s11748-020-01579-w. Epub 2021 Jan 4.
Staphylococcus lugdunensis infective endocarditis (IE) is very rare in children. A female neonote presented with fever on the 29th postoperative day after undergoing a modified Norwood procedure (right ventricular-pulmonary artery [RV-PA] conduit). Blood cultures were positive for S. lugdunensis. Echocardiography did not demonstrate vegetation. Therefore, we made a diagnosis of catheter-related bacteremia instead of IE. Cultures were negative 3 days after treatment initiation with intravenous vancomycin. One month after discharge, she developed acute hypoxia and could not be revived because of obstruction of RV-PA conduit with large vegetation. Even in S. lugdunensis bacteremia without IE, surgical treatment should be considered early.
金黄色葡萄球菌感染性心内膜炎（IE）在儿童中非常罕见。一名女新生儿在接受改良的 Norwood 手术后第 29 天出现发热，该手术为右心室-肺动脉（RV-PA）导管术。血液培养为金黄色葡萄球菌阳性。超声心动图未显示赘生物。因此，我们诊断为导管相关菌血症，而非 IE。静脉万古霉素治疗 3 天后，培养结果转为阴性。出院后 1 个月，她出现急性缺氧，因 RV-PA 导管内有大的赘生物而无法复苏。即使在无 IE 的金黄色葡萄球菌菌血症中，也应早期考虑手术治疗。
