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Recurrent infective endocarditis due to Aggregatibacter aphrophilus and Staphylococcus lugdunensis
L Hidalgo-García1, A Hurtado-Mingo2, P Olbrich1
1Hospital Universitario Virgen del Rocío, Pediatric Infectious Diseases and Immunopathology, Seville, Spain.
Klinische Padiatrie
|March 10, 2015
Summary
Paediatric infectious endocarditis (IE) can be caused by rare bacteria like Aggregatibacter aphrophilus and Staphylococcus lugdunensis. These infections may lead to severe complications, requiring prolonged treatment and sometimes surgery.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Paediatric infectious endocarditis (IE) is increasingly linked to uncommon microorganisms.
- Congenital heart disease presents a risk factor for IE in children.
Observation:
- A 4-year-old girl with congenital heart disease experienced two IE episodes.
- The causative agents were identified as Aggregatibacter aphrophilus and Staphylococcus lugdunensis, both rare in this age group.
- Despite antibiotic treatment, the patient developed pulmonary embolism, necessitating surgical intervention.
Findings:
- Aggregatibacter aphrophilus, a HACEK group bacterium, is a recognized cause of IE with variable prognosis.
- Staphylococcus lugdunensis, though a coagulase-negative staphylococci, exhibits aggressive behavior similar to Staphylococcus aureus, associated with high surgical rates and mortality in adults.
- This case highlights the potential severity and fatality of IE caused by these uncommon pathogens in children.
Implications:
- Clinicians should consider S. lugdunensis and A. aphrophilus in febrile patients, especially those with cardiac conditions, and rule out cardiac involvement.
- Management of paediatric IE caused by these organisms requires prolonged intravenous antibiotics and potentially surgical intervention for complicated cases.
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