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Commando Surgery in Infective Endocarditis by Streptococcus gallolyticus in an Adolescent: A Rare Case Report

Saroj Soumya1, Devika Chavan1, Balkrushna Pandit Garud1

  • 1Department of Pediatrics, Dr. D. Y. Patil Medical College Hospital and Research Institute, Pune, Maharashtra, India.

Annals of African Medicine
|May 15, 2026
PubMed

Insights

Pediatric infective endocarditis (IE) can be aggressive, even in previously healthy children. Early diagnosis and prompt surgical intervention are crucial for managing severe cases of this serious heart infection.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Infective endocarditis (IE) poses a significant health burden in India, especially in children with congenital heart disease (CHD).
  • Developing nations experience higher pediatric IE incidence due to diagnostic delays and limited access to specialized cardiac care.
  • Rheumatic heart disease and CHD are prevalent, increasing pediatric IE risk.

Purpose of the Study:

  • To highlight the aggressive presentation and management challenges of pediatric infective endocarditis.
  • To emphasize the critical role of early diagnosis and multidisciplinary intervention in severe pediatric IE cases.
  • To underscore the importance of prompt antimicrobial therapy and surgical management.

Main Methods:

  • Case report of a 14-year-old boy with no prior heart disease presenting with symptoms of IE.
  • Diagnostic evaluation included echocardiography and blood cultures.
  • Management involved intensive medical therapy followed by urgent cardiac surgery.

Main Results:

  • The patient presented with fever, cough, and chest pain, with echocardiography revealing aortic vegetation, severe regurgitation, and root abscess.
  • Blood cultures identified Streptococcus gallolyticus.
  • Despite antibiotic treatment, the patient required urgent aortic and mitral valve replacement but unfortunately could not be revived due to refractory ventricular tachycardia.

Conclusions:

  • Pediatric IE can exhibit rapid progression and aggressive behavior, even in previously healthy individuals.
  • Early diagnosis, appropriate antimicrobial therapy, and timely surgical intervention are vital for managing severe pediatric IE.
  • Multidisciplinary collaboration is essential for optimizing outcomes in complex pediatric IE cases with extensive cardiac involvement.

Keywords:
Abcès de la racine aortiqueCOMMANDO surgeryChirurgie COMMANDOEndocardite infectieuse pédiatriquePrise en charge chirurgicaleRemplacement valvulaire doubleStreptococcus gallolyticusTachycardie ventriculaire réfractairecongenital heart diseaseinfective endocarditisoutcome

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