Haboub Meryem, Khaldi Mohamed, Drighil Abdenasser
Cardiology Department, Hospital University Ibn Rochd, 8, Street Lahcen El Arjoun, Casablanca 20100, Morocco.
Eur Heart J Case Rep. 2025 May 24;9(6):ytaf267. doi: 10.1093/ehjcr/ytaf267. eCollection 2025 Jun.
Infective endocarditis on a patent ductus arteriosus (PDA) is a rare but serious condition that can lead to life-threatening complications, such as mycotic aneurysms. We report a case of endocarditis on a PDA, complicated by multiple mycotic aneurysms, including a partially ruptured aneurysm of the pulmonary artery (PA) trunk.
A 20-year-old female presented with progressive dyspnoea, worsening over 48 h, accompanied by fever. Echocardiography revealed a large pericardial effusion with cardiac tamponade, necessitating the drainage of 500 mL of haemorrhagic fluid. Imaging studies revealed a false aneurysm of the PA trunk, with contrast extravasation into the pericardial space. Blood cultures and pericardial fluid cultures were positive for . Emergency surgery involved resection of the aneurysm, ligation of the PDA, and pericardial drainage. The patient recovered after 4 weeks of intravenous antibiotics and was discharged with good clinical and biological outcomes.
This case illustrates the importance of early diagnosis and management of infective endocarditis associated with congenital heart defects, as the delay can result in severe complications such as aneurysm rupture.
动脉导管未闭（PDA）合并感染性心内膜炎是一种罕见但严重的疾病，可导致危及生命的并发症，如霉菌性动脉瘤。我们报告一例PDA合并心内膜炎，并发多个霉菌性动脉瘤，其中包括肺动脉（PA）主干部分破裂的动脉瘤。
一名20岁女性，出现进行性呼吸困难，在48小时内加重，并伴有发热。超声心动图显示大量心包积液并伴有心脏压塞，需要引流500毫升血性液体。影像学检查显示PA主干假性动脉瘤，造影剂外渗至心包腔。血培养和心包液培养均为阳性。急诊手术包括动脉瘤切除、PDA结扎和心包引流。患者在静脉注射抗生素4周后康复出院，临床和生物学指标良好。
该病例说明了早期诊断和治疗先天性心脏病相关感染性心内膜炎的重要性，因为延误可能导致严重并发症，如动脉瘤破裂。
