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Marantic endocarditis in children and young adults: clinical and pathological findings
Abstract:
The clinical and pathologic findings of 7 children and young adults with marantic endocarditis are reviewed. Cerebral embolic infarction attributable to the marantic vegetations occurred in 3 patients. The most common neurologic findings were altered mental status, seizures, and hemiplegia. Five of the 7 patients had had cardiac catheterization. Sepsis, pneumonia, hypoxia, disorders of coagulation, and renal failure were frequently present in these seriously ill patients. In each instance, the diagnosis of marantic endocarditis was unsuspected and established only at autopsy.
Insights
Marantic endocarditis in children and young adults often leads to cerebral embolic infarction, causing neurological issues like altered mental status and seizures. Diagnosis is frequently missed until autopsy in these critically ill patients.
Area of Science:
- Pediatric Cardiology
- Neurology
- Pathology
Background:
- Marantic endocarditis, a non-bacterial thrombotic endocarditis, is rare in pediatric populations.
- It is associated with hypercoagulable states and severe systemic illness.
- Clinical presentation can be subtle and often mimics other conditions.
Observation:
- This review examines 7 pediatric and young adult cases of marantic endocarditis.
- Cerebral embolic infarction was a significant complication in 3 patients.
- Common neurological findings included altered mental status, seizures, and hemiplegia.
Findings:
- Five patients had undergone cardiac catheterization.
- Associated conditions frequently observed were sepsis, pneumonia, hypoxia, coagulation disorders, and renal failure.
- The diagnosis of marantic endocarditis was consistently unsuspected and confirmed post-mortem.
Implications:
- Highlights the diagnostic challenges of marantic endocarditis in young patients.
- Emphasizes the need for increased clinical suspicion in critically ill children with neurological deficits.
- Suggests potential for earlier diagnosis and intervention if awareness is heightened.