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Endocarditis as the first presentation of AIDS in infancy
C A van Doorn1, R Yates, V T Tsang
1Department of Cardiology, Great Ormond Street Hospital for Children NHS Trust, London, UK.
Archives of Disease in Childhood
|November 3, 1998
Summary
This case report highlights a rare instance of Staphylococcus aureus endocarditis in an HIV-positive infant. It emphasizes the atypical presentation of severe infections in immunocompromised children with Acquired Immunodeficiency Syndrome (AIDS).
Area of Science:
- Pediatric Infectious Diseases
- Cardiology
- Immunology
Background:
- Endocarditis in pediatric patients, particularly those with Acquired Immunodeficiency Syndrome (AIDS), is poorly understood.
- Disseminated Staphylococcus aureus infections pose significant risks in immunocompromised individuals.
Observation:
- A two-month-old Ugandan infant with disseminated Staphylococcus aureus infection presented with an obstructive right ventricular vegetation requiring surgical intervention.
- Both the infant and his mother were diagnosed with Human Immunodeficiency Virus (HIV) infection.
Findings:
- This is the first reported case of disseminated Staphylococcus aureus infection with endocarditis and an obstructing vegetation in an HIV-positive infant with a structurally normal heart.
- The infant's initial signs and symptoms of endocarditis were atypical, characteristic of overwhelming infection in an immunocompromised host.
Implications:
- Severe infections, including endocarditis, can present atypically in immunocompromised patients, necessitating a high index of suspicion.
- Acquired Immunodeficiency Syndrome (AIDS) should be considered in the differential diagnosis of severe infections, especially in populations with endemic HIV.
- This case underscores the importance of considering HIV status in infants presenting with severe disseminated infections and cardiac involvement.