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Septic pulmonary embolism secondary to prosthetic conduit fungal endocarditis in a child

Yuki Nakayama1, Takeshi Shinkawa2, Mikiko Ishido3

  • 1Department of Cardiovascular Surgery, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan. nakayama.yuki@twmu.ac.jp.

General Thoracic and Cardiovascular Surgery
|November 19, 2022
PubMed

Insights

A pediatric patient with fungal endocarditis and septic pulmonary embolism underwent successful pulmonary vegetectomy and conduit replacement. This intervention resolved the infection and embolism, leading to a good outcome two years post-surgery.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatric Surgery

Background:

  • A pediatric patient with a history of corrected transposition of the great arteries underwent a Senning/Rastelli procedure.
  • The patient developed prosthetic fungal endocarditis caused by Candida parapsilosis, leading to significant vegetation growth.

Observation:

  • Progressive septic pulmonary embolism occurred despite antifungal treatment.
  • Emergent surgery was required due to the severity of the condition.

Findings:

  • Pulmonary vegetectomy and replacement of the infected right ventricle-to-pulmonary artery conduit were performed under moderate hypothermic circulatory arrest.
  • The surgical intervention successfully removed the infected vegetation and conduit.

Implications:

  • This case highlights the successful management of complex fungal endocarditis in a pediatric patient with congenital heart disease.
  • Aggressive surgical intervention combined with antifungal therapy can be effective in treating prosthetic valve endocarditis with embolic complications.

Keywords:
ChildExtracorporeal membrane oxygenationFungal infective endocarditisHypothermic circulatory arrestPulmonary vegetectomy

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