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.

REFERENCES

1. Christensen JJ, Facklam RR. Granulicatella and Abiotrophiaspecies from human clinical specimens. J Clin Microbiol 2001; 39: 3520–3. DOI: 10.1128 / JCM.39.10.3520-3523.2001

2. Gupta S, Sakhuja A, McGrath E, Asmar B. Trends, microbiology,and outcomes of infective endocarditis in childrenduring 2000-2010 in the United States. Congenit Heart Dis2017; 12: 196. DOI: 10.1111 / chd.12425

3. Ware AL, Tani LY, Weng HY, Wilkes J, Menon SC. Resourceutilization and outcomes of infective endocarditisin children. J Pediatr 2014; 165: 807. DOI: 10.1016 /j.jpeds.2014.06.026

4. Rushani D, Kaufman JS, Ionescu-Ittu R, Mackie AS, PiloteL, Therrien J, et al. Infective endocarditis in children withcongenital heart disease: cumulative incidence and predictors.Circulation 2013; 128: 1412-19. DOI: 10.1161 /CIRCULATIONAHA.113.001827

5. Baltimore RS, Gewitz M, Baddour LM, Beerman LB, JacksonMA, Lockhart PB, et al. Infective endocarditis in childhood:2015 update: A scientific statement from the AmericanHeart Association. Circulation 2015; 132: 1487-1515. DOI:10.1161 / CIR.0000000000000298

6. Leyva Salmerón, Mirna Xitlalli. Endocarditis infecciosaen el Instituto Nacional de Pediatría en un periodo de 10años. (Trabajo de grado de especialización). UniversidadNacional Autónoma de México, México. 2018. Recuperadode https://repositorio.unam.mx/contenidos/153069

7. Shailaja TS, Sathiavathy KA, Govindan U. Infective endocarditiscaused by Granulicatella adiacens. Indian Heart J 2013;65: 447-449. DOI: 10.1016 / j.ihj.2013.06.014

8. De Luca M, Amodio D, Chiurchiù S, Casteluzzo MA, Caló FI,D’Argenio P. Granulicatella bacteraemia in children: twocases and review of the literature. BMC Pediatrics 2013;13: 61. DOI https://doi.org/10.1186/1471-2431-13-61

9. Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, CasaltaJP, Del Zotti F, et al. Guía ESC 2015 sobre el tratamiento dela endocarditis infecciosa. Rev Esp Cardiol 2016; 69: 1-49.DOI: 10.1016/j.recesp.2015.11.015

10. Boils CL, Nasr SH, Walker PD, Couser WG, Larsen CP. Updateon endocarditis-associated glomerulonephritis. Kidney Int2015; 87:1241-1249. DOI: 10.1038 / ki.2014.424

11. Ritchie BM, Hirning BA, Stevens CA, Cohen SA, DeGradoJR. Risk factors for acute kidney injury associated withthe treatment of bacterial endocarditis at a tertiary academicmedical center. J Chemother 2017; 29: 292-298. DOI:10.1080 / 1120009X.2017.1296916