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Mitral valve replacement in a 3.9-kg infant with fungal endocarditis: A case report

Zornitsa Vassileva1, Ventsislav Boshnakov1, Anna Kaneva1

  • 1Department of Pediatric Cardiology, University National Heart Hospital, Sofia, Bulgaria.

Turk Gogus Kalp Damar Cerrahisi Dergisi
|October 28, 2022
PubMed

Insights

Fungal endocarditis in an infant led to valve destruction and heart failure despite surgery. Anticoagulant non-compliance caused prosthesis thrombosis, resulting in fatal pulmonary edema.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Fungal endocarditis is a rare but serious infection affecting heart valves, particularly in infants.
  • Early diagnosis and intervention are crucial for managing this condition and preventing severe complications.

Observation:

  • A three-month-old infant presented with fungal endocarditis of the mitral valve and cerebral embolism.
  • Initial treatment included antifungal therapy and valve-sparing surgery, but a relapse occurred with severe mitral regurgitation and heart failure.

Findings:

  • A second surgery for mitral valve replacement was successful.
  • However, subsequent non-compliance with anticoagulant therapy led to prosthetic valve thrombosis.
  • This complication resulted in acute pulmonary edema and the patient's death.

Implications:

  • This case highlights the challenges in managing pediatric fungal endocarditis and the critical importance of lifelong adherence to anticoagulant therapy after prosthetic valve replacement.
  • It underscores the need for vigilant monitoring and patient/family education to prevent life-threatening complications.
Keywords:
Endocarditisfungalmitral valvereplacementvegetation

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