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Fatal Staphylococcus Aureus Endocarditis Misdiagnosed as Multisystem Inflammatory Syndrome in Children

Ana Peña-Moreno1, Laura Torres-Soblechero1, María López-Blázquez2

  • 1From the Pediatrics Department.

The Pediatric Infectious Disease Journal
|November 29, 2021
PubMed

Insights

A child with Staphylococcus aureus mitral endocarditis was misdiagnosed as multisystem inflammatory syndrome. This case highlights diagnostic challenges and fatal brain hemorrhage post-cardiac intervention.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Neurology

Background:

  • Staphylococcus aureus mitral endocarditis can present with complex symptoms.
  • Multisystem inflammatory syndrome associated with coronavirus disease 2019 (MIS-C) shares overlapping clinical features.

Observation:

  • A 10-year-old male presented with symptoms initially suggestive of MIS-C.
  • The patient was diagnosed with Staphylococcus aureus mitral endocarditis.
  • Cardiac intervention was followed by a fatal brain hemorrhage.

Findings:

  • This case contrasts with studies where microbleeds did not elevate hemorrhagic stroke or mortality risk.
  • The initial misdiagnosis potentially delayed appropriate treatment for infective endocarditis.

Implications:

  • Accurate and timely diagnosis of infective endocarditis is critical in pediatric patients.
  • Clinicians should maintain a high index of suspicion for bacterial endocarditis even with MIS-C prevalence.
  • Understanding risk factors for intracranial hemorrhage in endocarditis patients is crucial.

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