Challenges in the diagnosis and management of Granulicatella elegans endocarditis in a 9-year-old child.
BMJ Case Rep
; 14(2)2021 Feb 18.
Article
in English
| MEDLINE | ID: covidwho-1090979
ABSTRACT
A 9-year-old child, with a background of repaired pulmonary atresia and Ebstein's anomaly, presented with fever, night sweats and lethargy. Blood cultures grew Granulicatella elegans, a nutritionally variant Streptococcus and known cause of infective endocarditis (IE). Echocardiogram revealed no clear vegetation, but increased stenosis of the right ventricle to pulmonary artery conduit. The child was successfully managed with high-dose benzylpenicillin, completing 2 weeks in the hospital, and was discharged to complete the ï¬nal 4 weeks of therapy with ceftriaxone in the community, as per European Society of Cardiology guidance. IE caused by any Granulicatella species is rare, with infection due to G. elegans rarer still. It is a Gram-positive bacteria that presents a diagnostic challenge due to non-speciï¬c symptoms at presentation and diï¬culty in growing the organism on culture medium. We present a case of G. elegans endocarditis in a young child, which illustrates the challenges in managing this condition and the importance of considering atypical organism endocarditis in children presenting with fever of unknown origin, in particular those with a background of congenital cardiac disease. We review the literature on Granulicatella endocarditis, and brieï¬y discuss the challenges of managing this condition in a child with an autism spectrum disorder and learning diï¬culties.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Gram-Positive Bacterial Infections
/
Endocarditis
/
Endocarditis, Bacterial
/
Autism Spectrum Disorder
Type of study:
Case report
/
Diagnostic study
Topics:
Variants
Limits:
Child
/
Humans
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Bcr-2020-240079
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