Case report: Staphylococcus aureus endocarditis in 2 premature newborns

Abstract

Rationale: Neonatal infectious endocarditis (IE) in a healthy heart is rare. The infectious agents most frequently found in newborns are Staphylococcus aureus and fungi. Infection at the site of central intravenous catheter is generally thought to be the cause of this pathology.

Patient concerns: We present 2 cases of premature newborns whose condition is evolving positively. They presented S aureus endocarditis during their first week of life.

Diagnosis: Modified Duke diagnostic criteria-from clinical, echocardiogram and microbiological findings-based on those used for adults, can be used for children and newborns, but the very low prevalence of neonatal IE often delays diagnosis. Diagnosis on the basis of transthoracic heart ultrasound requires an extension report, given the very high embolic risk.

Intervention: In the large majority of cases, long-term antibiotic therapy efficaciously treats the infection, although sometimes surgery is necessary. These 2 newborns needed only antibiotic therapy.

Outcome: Despite the various complications, especially embolic, these 2 children are followed and are doing well.

Lessons: Long-term pediatric heart monitoring combined with prophylactic antibiotics are essential, according to the European Society of Cardiology guidelines.

Figure 1

Vegetation on the tricuspid valve by echocardiography.