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Ductus arteriosus-associated infective endarteritis: Lessons from the past, future perspective
Alessia Callegari1, Barbara Burkhardt1, Christa Relly2
1Pediatric Cardiology, Department of Surgery, Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland.
Patent ductus arteriosus infective endarteritis (PDA-IE) is a rare but serious condition. Early diagnosis and antibiotic treatment are crucial for recovery, even after PDA closure.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Neonatology
Background:
- Patent ductus arteriosus (PDA) closure is routine, yet PDA-associated infective endarteritis (PDA-IE) remains a rare complication.
- PDA-IE can occur during ductus arteriosus patency or shortly after its obliteration, necessitating clinical vigilance for unexplained fever.
Observation:
- A 7-week-old infant with Staphylococcus aureus sepsis presented with a new heart murmur.
- Transthoracic echocardiography revealed PDA-IE at the pulmonary artery end of an obliterated PDA.
Findings:
- Successful antibiotic treatment led to vegetation reduction and complete infant recovery.
- Literature review confirmed PDA-IE as a rare, life-threatening condition in neonates and infants, even post-closure.
Implications:
- Transthoracic echocardiography is valuable in diagnosing PDA-IE in septic neonates with bacteremia, especially with fever of unknown origin or new heart murmurs.
- Clinicians must maintain a high index of suspicion for PDA-IE in infants presenting with sepsis and cardiac findings.
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