Baptistella Amanda, Rossato Ana Júlia A, de Gusmão Beatriz C, Cunha Carolina M, Trafane Luiza F, Colbachini Paulo C M
Pontifical Catholic University of Campinas School of Medicine, Campinas, Brazil.
Pediatric Residence Program, Pontifical Catholic University of Campinas Hospital, Campinas, Brazil.
Front Pediatr. 2023 Oct 6;11:1200215. doi: 10.3389/fped.2023.1200215. eCollection 2023.
patients with congenital cardiopathies are the main group at risk for infective endocarditis (IE) in the pediatric population. Fungal etiology is responsible for 2%-4% of all IEs, and the genus is an increasingly prevalent cause of infections in human beings.
We describe a 9-year-old male with multiple surgical procedures to correct congenital cardiopathy defects, including insertion of RV-PA conduit, who was admitted due to suspicion of pneumonia and needed a surgical approach after being diagnosed with a mycotic pseudoaneurysm in the right ventricle's outflow tract, with dilation of the RV-PA conduit. The conduit was removed and antifungal treatment was started with Voriconazole after the agent was identified (), with satisfactory therapeutic response. Approximately 4 years later, the patient was readmitted, presenting with intermittent fever, associated with nocturnal diaphoresis, dry cough, anxiety and chest pain. Vegetations consistent with were evidenced in the RV-PA conduit, and a surgical approach was once again necessary.
diagnostic methods and treatment of endocarditis aren't yet standardized, and recurrent surgical approaches are needed due to the inefficacy of antifungal treatment.
先天性心脏病患者是儿科人群中感染性心内膜炎（IE）的主要风险群体。真菌病因在所有IE中占2%-4%，并且该属是人类感染中日益普遍的病因。
我们描述了一名9岁男性，他接受了多次手术以纠正先天性心脏病缺陷，包括右心室-肺动脉导管植入术，因怀疑肺炎入院，在被诊断出右心室流出道霉菌性假性动脉瘤并伴有右心室-肺动脉导管扩张后需要手术治疗。导管被移除，在确定病原体后开始使用伏立康唑进行抗真菌治疗，治疗反应令人满意。大约4年后，患者再次入院，表现为间歇性发热，伴有夜间出汗、干咳、焦虑和胸痛。在右心室-肺动脉导管中发现了符合[此处原文缺失相关内容]的赘生物，再次需要手术治疗。
[此处原文缺失相关内容]性心内膜炎的诊断方法和治疗尚未标准化，由于抗真菌治疗无效，需要反复进行手术治疗。
