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一例罕见的小儿感染性心内膜炎，最初表现为一名既往健康儿童的脑膜炎。

A Rare Case of Pediatric Infective Endocarditis Initially Presenting as Meningitis in a Previously Healthy Child.

作者信息

Abdulsalam Tuqa A, Khan Farheen, Hussein Haytham, Alhammadi Moza, Magzoub Alia

机构信息

General Pediatrics, Al Jalila Children's Hospital, Sharjah, ARE.

General Pediatrics, Al Jalila Children's Speciality Hospital, Dubai, ARE.

出版信息

Cureus. 2025 Jul 11;17(7):e87712. doi: 10.7759/cureus.87712. eCollection 2025 Jul.

DOI:10.7759/cureus.87712
PMID:40786311
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12335882/
Abstract

Infective endocarditis (IE) is a rare but life-threatening condition in children, particularly in those without heart disease. Delayed diagnosis can lead to serious systemic complications. We report the case of an eight-year-old previously healthy girl, initially misdiagnosed with bacterial meningitis, who developed multiple septic embolic events (cerebral infarcts, digital gangrene, and splenic and renal infarction) despite being on antibiotic therapy. Repeat echocardiograms revealed mitral valve vegetation and an aortic root abscess. Blood cultures (aerobic and anaerobic) grew methicillin-sensitive (MSSA). She underwent successful surgical management via a modified Ross procedure, followed by a six-week course of intravenous (IV) flucloxacillin, resulting in full recovery. This case underscores the diagnostic challenges of pediatric IE in patients without known cardiac risk factors and highlights the critical role of serial imaging, multidisciplinary care, and early surgical intervention in achieving favorable outcomes.

摘要

感染性心内膜炎（IE）在儿童中虽罕见但危及生命，尤其是在无心脏病的儿童中。延迟诊断可导致严重的全身并发症。我们报告一例8岁既往健康女孩的病例，最初被误诊为细菌性脑膜炎，尽管接受了抗生素治疗，仍发生了多次脓毒性栓塞事件（脑梗死、手指坏疽以及脾和肾梗死）。重复超声心动图显示二尖瓣赘生物和主动脉根部脓肿。血培养（需氧和厌氧）培养出对甲氧西林敏感的金黄色葡萄球菌（MSSA）。她通过改良Ross手术成功接受了外科治疗，随后接受了为期六周的静脉注射氟氯西林治疗，最终完全康复。该病例强调了在无已知心脏危险因素的儿科IE患者中的诊断挑战，并突出了系列影像学检查、多学科护理以及早期手术干预在取得良好预后方面的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/7cb9f80c1260/cureus-0017-00000087712-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/d9e607a253f7/cureus-0017-00000087712-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/865e948bb0ee/cureus-0017-00000087712-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/0c9b7cacabc3/cureus-0017-00000087712-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/312330f70c7d/cureus-0017-00000087712-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/58d3590cd715/cureus-0017-00000087712-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/3c5fdbc50a97/cureus-0017-00000087712-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/423c5d5b8fca/cureus-0017-00000087712-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/7cb9f80c1260/cureus-0017-00000087712-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/d9e607a253f7/cureus-0017-00000087712-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/865e948bb0ee/cureus-0017-00000087712-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/0c9b7cacabc3/cureus-0017-00000087712-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/312330f70c7d/cureus-0017-00000087712-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/58d3590cd715/cureus-0017-00000087712-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/3c5fdbc50a97/cureus-0017-00000087712-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/423c5d5b8fca/cureus-0017-00000087712-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d833/12335882/7cb9f80c1260/cureus-0017-00000087712-i08.jpg

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Neurologic complications of infective endocarditis in children.儿童感染性心内膜炎的神经并发症。
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