Document Detail


Mesenteric pseudoaneurysm and cerebral stroke as sequelae of infective endocarditis in an adolescent.
MedLine Citation:
PMID:  18926234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Infective endocarditis is uncommon in children, and there is a paucity of literature concerning cases that involve unique or resistant organisms. Complications associated with infective endocarditis are distinctly rare and poorly characterized, especially unusual sequelae such as pseudoaneurysm of the abdominal mesentery. Our case involves an adolescent who presented with several weeks of fever and eventual cardiac murmur and was found to have vancomycin-resistant Enterococcus growing as a vegetation on a previously undiagnosed bicuspid aortic valve. He had a cerebral stroke presenting as Broca's aphasia before cardiac surgery, as well as a superior mesenteric artery pseudoaneurysm several days postoperatively. The case highlights some of the serious surgical complications that can occur in young persons with infective endocarditis, as well as many of the problems involved in managing a patient with highly resistant pathogens and a surgically challenging location of the aneurysm.
Authors:
Eric J Dziuban; Daniel H Teitelbaum; Arsala Bakhtyar; Jyoti Kandlikar; Sean McLean; Sai Yarram; Mark W Russell; Richard G Ohye; Ramon Sanchez
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  43     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-17     Completed Date:  2009-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1923-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics and Communicable Diseases, CS Mott's Children's Hospital, University of Michigan, Ann Arbor, MI 48109, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aneurysm, False / etiology*,  surgery
Aneurysm, Infected / etiology*,  surgery
Anti-Bacterial Agents / therapeutic use*
Aortic Valve / abnormalities,  microbiology,  surgery
Aphasia, Broca / etiology*
Combined Modality Therapy
Endocarditis, Bacterial / complications*,  drug therapy,  surgery
Enterococcus / drug effects,  isolation & purification*
Gram-Positive Bacterial Infections / complications*,  drug therapy,  surgery
Heart Valve Prosthesis Implantation
Humans
Infarction, Middle Cerebral Artery / etiology*
Intracranial Embolism / etiology*
Male
Mesenteric Artery, Superior / pathology*,  surgery
Pulmonary Valve / surgery,  transplantation
Streptococcal Infections / complications*,  drug therapy,  surgery
Vancomycin Resistance
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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