Right-sided endocarditis from Staphylococcus lugdunensis in a patient with tetralogy of Fallot

Area of Science:

• Cardiology
• Infectious Diseases
• Pediatrics

Background:

• Infective endocarditis (IE) affects native and prosthetic heart valves, often caused by bacterial pathogens.
• Pediatric IE commonly involves Staphylococcus aureus, streptococci, enterococci, and coagulase-negative staphylococci (CoNS).
• CoNS can be difficult to identify due to potential culture contamination, posing a diagnostic challenge.

Purpose of the Study:

• To report a case of right-sided infective endocarditis in a pediatric patient.
• To highlight Staphylococcus lugdunensis as an emerging cardiotropic pathogen.
• To discuss the clinical presentation and management of IE caused by S. lugdunensis in a complex pediatric case.

Main Methods:

• Case report of a pediatric patient with a history of repaired tetralogy of Fallot.
• Clinical presentation, diagnostic workup, and microbiological identification of the causative pathogen.
• Review of relevant literature on infective endocarditis and Staphylococcus lugdunensis.

Main Results:

• The patient presented with symptoms consistent with right-sided infective endocarditis.
• Blood cultures identified Staphylococcus lugdunensis as the causative agent.
• Staphylococcus lugdunensis, a CoNS, demonstrated cardiotropic properties similar to Staphylococcus aureus.

Conclusions:

• Staphylococcus lugdunensis is an important emerging pathogen in infective endocarditis, even in pediatric patients with congenital heart disease.
• Accurate identification of CoNS, including S. lugdunensis, is crucial for appropriate treatment and management of IE.
• This case underscores the need for vigilance in diagnosing IE caused by less common pathogens in pediatric populations.