2022, Number 3
Acta Pediatr Mex 2022; 43 (3)
Infective endocarditis due to Granulicatella adiacens in a child with congenital heart disease. Case Report
Nery-Zavaleta CY, Nario-Lazo V, Genaro-Saldaña SV
Language: Spanish
References: 11
Page: 174-178
PDF size: 265.95 Kb.
ABSTRACT
Introduction: Infective endocarditis (IE) due to Granulicatella adiacens is a rare disease
in children, but with significant morbidity and mortality. Children with congenital
heart disease (CHD) are at increased risk of developing IE, and Granulicatella species
endocarditis can be difficult to treat.
Present the case: Seven-year-old male patient with a history of pulmonary atresia,
patent ductus arteriosus (PDA), uncorrected ventricular septal defect (VSD) and multiple
aortopulmonary collaterals (MAPCAS), who presented signs and symptoms of IE,
with vegetations on echocardiogram and a positive blood culture for Granulicatella
adiacens. He received ceftriaxone plus vancomycin for six weeks and gentamicin
for the first two weeks. The patient developed immune-mediated glomerulonephritis
and acute renal failure. A clinical and laboratory improvement was achieved; and no
vegetation was found at discharge.
Conclusions: IE due to Granulicatella is an entity that should be considered in the
pediatric population with CHD, especially of the cyanotic type. Treatment with β-lactams
plus aminoglycosides is usually first-line empirical therapy. Vancomycin may also be
an alternative drug option in resistant strains. We suggest an approximate follow-up
of kidney involvement that can develop as a complication of IE itself, as well as due
to drug nephrotoxicity.
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