2003, Number 4
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ABSTRACTBacterial endocarditis is a rare entity in pediatrics, generally associated to congenital cardiac defects. Even though the etiology is confirmed in most of the cases, some patients received empirical therapy for common isolated microorganisms. Linezolid is an oxazolidinone, with activity against Gram-positive cocci resistant to penicillin, methicillin vancomycin. Objective. To describe the results of the treatment with linezolid in a patient with bacterial endocarditis and bibliographic review. Description of the case. Female, 8 years of age, with congenital heart disease (double pulmonary lesion and patent ductus arterious), and diagnosis of bacterial endocarditis, confirmed by echocardiography four vegetations of variable sizes, from 12 to 15 mm, pediculated, in the pulmonary valve and internal right wall of pulmonary artery). She began treatment with penicillin G, plus amikacin. After an inital period of clinical response, fever reappeared at 7° day, and at two weeks, the size of the vegetations was bigger and new ones were noted. By consense, penicillin G was substituted with linezolid, with clinical improvement at two weeks, and cure at six weeks. Conclusions. Linezolid could be an alternative to conventional treatment for bacterial endocarditis in children without clinical improvement. Controlled randomized clinical trials are needed to prove its efficacy in this clinical entity.
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