Ewha Med J.  2017 Oct;40(4):171-174. 10.12771/emj.2017.40.4.171.

Infective Endocarditis Caused by Neisseria cinerea in a 7-Year-Old Girl Who Had Undergone Surgical Pulmonary Valve Replacement

• Kim MS
• Kim SH
• Jang SI
• Lee SY

• KMID: 2393723
• DOI: http://doi.org/10.12771/emj.2017.40.4.171

Abstract

A 7-year-old girl was admitted to the emergency department with a 2-week history of fever and general weakness. She had been diagnosed with tetralogy of Fallot and received surgical repair. Pulmonary prosthetic valve replacement was performed in January 2014 because of severe pulmonary regurgitation and moderate right ventricle dilatation. Echocardiography revealed suspicious vegetation around the prosthetic pulmonary valve. Neisseria cinerea was confirmed in blood culture. We diagnosed with bacterial infective endocarditis, and administered empirical intravenous antibiotics for endocarditis. However, the fever and general weakness continued, with mild muscle aches and coughing. Thus, we performed a chest radiography and pneumonia workup. Therefore, she was diagnosed with mycoplasma pneumonia and given oral clarithromycin twice daily for 2 weeks. She was successfully treated with antibiotics for 46 days. We report the first case of infective endocarditis caused by N. cinerea in Korea.

Keyword

Endocarditis; Neisseria cinerea; Infection

MeSH Terms

Anti-Bacterial Agents
Child*
Clarithromycin
Cough
Dilatation
Echocardiography
Emergency Service, Hospital
Endocarditis*
Female*
Fever
Heart Ventricles
Humans
Korea
Neisseria cinerea*
Neisseria*
Pneumonia
Pneumonia, Mycoplasma
Pulmonary Valve Insufficiency
Pulmonary Valve*
Radiography
Tetralogy of Fallot
Thorax
Anti-Bacterial Agents
Clarithromycin

Figure

• 

  Fig. 1 An echocardiography image obtained on the day of admission showed a mass-like vegetation (arrow) at the pulmonary valve. Ao, Aorta; MPA, main pulmonary artery; PV, pulmonary valve.

• 

  Fig. 2 (A) A CT scan showed the low density soft tissue thickening at the inferior portion of the prosthetic pulmonary valve (arrow). (B) A CT scan showed patchy consolidation (arrow) in the right lower lung.

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