Endocardite por Staphylococcus aureus no puerpério de portadora de prolapso de valvas mitral e tricúspide / Staphylococcus aureus endocarditis in a puerperal woman with mitral and tricuspid valves prolapse

RESUMO

Mulher de 17 anos com prolapso de valvas mitral e tricúspide com sinais de degeneraçäo mixomatosa apresentou infecçäo puerperal por Staphylococcus aureus, com sepse e múltiplas embolias sépticas (órbita e globo ocular direitos, polegar esquerdo, baço, flegmäo em gastrocnêmio esquerdo), resultando histerectomia total dno 10§ dia pós-parto e enucleaçäo do globo ocular direito no 16§. Foram diagnosticadas endocardite infecciosa e insuficiência mitral aguda e realizada substituiçäo mitral no 13§ dia pós-parto, ocorrendo bloqueio átrio-ventricular total (BAVT) - necessitando de utilizaçäo de estimulaçäo artificial temporária - no 14§ dia pós-parto, bem como endocardite e insuficiência na tricúspide no 46§ dia pós-parto. A paciente recebeu alta no 62§ dia pós-parto em boas condiçöes clínicas, após término da antibioticoterapia

ABSTRACT

A 17-year-old woman with mitral and tricuspid valve prolapse and mizomatous degeneration presented puerperal infection by Staphylococcus aureus with clinical picture of sepsis and multiple septic embolism (right eye, left thumb, spleen, and left calf). She underwent total hysterectomy on the 10th day postdelivery and right eye enucleation on the 16th. Temporary total AV block occurred on the 14th day with temporary external pacing during the next couple of days. Acute endocarditis with acute mitral regurgitation was diagnosed on the 13th day, demanding immediate valve replacement. On the 46th day she developed moderate tricuspid valve regurgitation due to another episode of endocarditis. Final clinical discharge took place on the 62nd day after antibiotic therapy completion.