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2022, Number 2

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Enf Infec Microbiol 2022; 42 (2)

Pacemaker-associated infectious endocarditis in infant with neonatal lupus

González AE, Aceves BCA. Reyes GU, Yalaupari MJP

Language: Spanish
References: 85
Page: 82-90
PDF size: 253.75 Kb.


ABSTRACT

Neonates with systemic lupus erythematosus may present with complete atrioventricular block (avb), secondary to the autoimmune disease. These patients require the installation of a pacemaker.
Clinical case. The case of an infant is presented, son of an apparently healthy 35-year-old mother, normal pregnancy up to 24 weeks of gestation, in obstetric ultrasound detecting fetal bradycardia, various laboratory studies are performed on the mother found igg antibodies anti-ro positive. Pregnancy was terminated by caesarean section at 39 weeks. Male live product was born with crying and spontaneous breathing with persistent bradycardia, electrocardiogram with avb, in the first 24 hours of life an epicardial pacemaker was installed, the next day a single dose of immunoglobulin was administered. At two weeks, he presented fever, skin erosion and percutaneous exposure of the pacemaker leads, a moderate amount of yellowish discharge that was not fetid. By transthoracic echocardiogram, infectious endocarditis was diagnosed, for which he was sent to our medical center. The echocardiogram was repeated, observing images with irregular hyperdensities attached to the electrode body 3 × 5 × 10.8 mm and 5.1 × 3.8 mm, without erratic movement, heart failure with lvef of 15% and pericardial effusion. Vancomycin/amphotericin b lipid complexes were administered. The pacemaker was removed, however, he presented progressive bradycardia refractory to treatment and triggered irreversible cardiac-respiratory arrest.


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