Recurrent mitral regurgitation and left atrial aneurysm in a pediatric patent: A complex case of infective endocarditis

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Cardiovascular Surgery

Background:

• Infective endocarditis (IE) is a serious infection affecting heart valves and surfaces.
• Recurrent IE poses diagnostic and management challenges, particularly in pediatric populations.
• Pediatric IE can present with varied and sometimes subtle clinical manifestations.

Observation:

• A 6-year-old boy with prior IE experienced recurrent disease.
• Symptoms included left hip arthritis and severe mitral regurgitation.
• A rare complication, a left atrial pseudoaneurysm, was identified.

Findings:

• The recurrent infective endocarditis manifested atypically, lacking classic fever and systemic symptoms.
• Advanced imaging, including echocardiography, was essential for detecting the recurrence and pseudoaneurysm.
• Surgical repair was successfully performed, guided by imaging findings.

Implications:

• This case emphasizes the need for high clinical suspicion in pediatric patients with a history of IE, even with atypical presentations.
• Echocardiography and other imaging modalities are critical for timely diagnosis and effective management of recurrent IE and its complications.
• Understanding rare complications like left atrial pseudoaneurysms is vital for comprehensive pediatric cardiovascular care.