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Right-sided endocarditis due to Salmonella typhi

J P du Plessis1, K Govendrageloo, S E Levin

  • 1Division of Pediatric Cardiology, Baragwanath Hospital, University of the Witwatersrand, PO Bertsham, 2013, Johannesburg, South Africa.

Pediatric Cardiology
|October 27, 1997
PubMed
Summary

Salmonella typhi caused right-sided endocarditis in a child, affecting the tricuspid valve. Transesophageal echocardiography confirmed vegetations, leading to successful treatment with antibiotics.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Pediatrics

Background:

  • Right-sided endocarditis is uncommon in children, particularly without traditional risk factors.
  • Salmonella typhi is a rare cause of infective endocarditis.

Observation:

  • A child presented with classic typhoid fever symptoms and tricuspid regurgitation.
  • Initial transthoracic echocardiography showed tricuspid regurgitation but lacked definitive endocarditis signs.
  • Transesophageal echocardiography was crucial for visualizing tricuspid valve vegetations.

Findings:

  • The case confirmed Salmonella typhi as the causative agent of native tricuspid valve endocarditis.
  • Diagnosis required advanced imaging (transesophageal echocardiography) to detect subtle vegetations.

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  • The patient had no human immunodeficiency virus (HIV) or history of intravenous drug use.

    • Implications:

    • Highlights the importance of considering Salmonella typhi in pediatric endocarditis, even without typical risk factors.
    • Emphasizes the diagnostic utility of transesophageal echocardiography in complex endocarditis cases.
    • Demonstrates effective antibiotic treatment regimens for Salmonella typhi endocarditis.