Ender Embolik Fenomenler ile Seyreden İnfektif Endokardit Vakası

Öz

İnfektif endokardit çocukluk çağında ender olarak karşımı- za çıksa da önemli bir morbidite ve mortalite nedeni olma- ya devam etmektedir. Doğumsal kalp hastalıkları ve roma- tizmal kapak hasarları infektif endokardit için en önemli risk faktörleri olup, yapılan kardiyak cerrahi ve girişimsel müdahaleler riski daha da artırmaktadır. Hastalığın en önemli komplikasyonları konjestif kalp yetersizliği ve embolik fenomenlerdir. Bu makalede aort koarktasyonu nedeniyle balon anjioplasti yapıldıktan iki ay sonra akut iskemik inme nedeniyle başvuran ve endokardit tanısı alan 4 yaşında erkek hasta sunuldu. İzlemde tedavi altındayken septik embolilere bağlı parotit ve kas içi abse komplikas- yonları da gelişti

Anahtar Kelimeler

• İnfektif endokardit,inme,çocuk

Rarely Seen Embolic Events Associated with Infective Endocarditis: Case Report

Öz

Although infective endocarditis is an uncommon disease during childhood, it has high rates of morbidity and morta- lity. Congenital heart diseases and rheumatic valve dama- ges are the most important predisposing factors for infecti- ve endocarditis and the risk is increased by heart surgery and interventional treatments. The most significant compli- cations of infective endocarditis are congestive heart failu- re and embolic events. We report a four-year-old boy pre- sented with acute ischemic stroke two months following balloon angioplasty for aortic coarctation diagnosed as infective endocarditis. During follow-up, parotid and intra- muscular abscess formation because of septic embolism were observed as complications of infective endocarditis

Anahtar Kelimeler

• Infective endocarditis,stroke,children

Kaynakça

1. 1. Taubert KA, Gewitz M. Infective endocarditidis. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF, editors. Moss and Adam’s heart disease in ınfants, children and adolescent. 7th ed. Philedelphia: Lippincott Williams&Wilkins; 2008. p.1299- 312.
2. 2. Danilowicz D. Infective endocarditis. Pediatr Rev 1995;16: 148-54. http://dx.doi.org/10.1542/pir.16-4-148 PMid:7731910
3. 3. Ferrieri P, Gewitz M, Gerber M, et al. Uniqe features of infective endocaditis in childhood. Pediatrics 2002;109:931- 43. http://dx.doi.org/10.1542/peds.109.5.931 PMid:11986458
4. 4. Strom BL, Abrutyn E, Berlin JA, et al. Risk factors for infective endocarditis: oral hygiene and nondental exposures. Circulation 2000;102:2842-8. PMid:11104742
5. 5. Bayer A, Bolger A, Taubert K, et al. Diagnosis and management of infective endocarditis and its complications. Circulation 1998;98:2936-48. PMid:9860802
6. 6. Harris PS, Cobbs CG. Cardiac, cerebral, and vascular complications of infective endocarditis. Cardiol Clin 1996;14:437- 50. http://dx.doi.org/10.1016/S0733-8651(05)70294-0
7. 7. Kanter MC, Hart RG. Neurologic complications of infective endocarditis. Neurology 1991;41:1015-20. PMid:1829793
8. 8. Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med 2001;345:1318-30. http://dx.doi.org/10.1056/NEJMra010082 PMid:11794152

9. 9. Salgado AV. Central nervous system complications of infective endocarditis. Stroke 1991;26:19-22.
10. 10. Venkatesan C, Wainwright MS. Pediatric endocarditis and stroke: a single-center retrospective review of seven cases. Pediatr Neurol 2008;38:243-7. http://dx.doi.org/10.1016/j.pediatrneurol.2007.12.009 PMid:18358401 PMCid:2409276
11. 11. Coward K, Tucker N, Darville T. Infective endocarditis in Arkansas children from 1990 through 2002. Pediatr Infect Dis J 2003;22:1048-52. http://dx.doi.org/10.1097/01.inf.0000101186.88472.b5 PMid:14688563
12. 12. Hızlı Ş, Arman B. Çocukluk yaş grubunda infektif endokarditlerin değerlendirmesi: 11 yıllık deneyimin sunumu. Türk Kardiyoloji Dern Arş 2005;33:141-8.
13. 13. Rohmann S, Erbel R, Darius H, et al. Prediction of rapid versus prolonged healing of infective endocarditis by monitoring vegetation size. J Am Soc Echocardir. 1991;4:465-74. PMid:1742034
14. 14. Vuille C, Nidorf M, Weyman AE, Picard MH. Natural history of vegetation during successful medical treatment of endocarditis. Am Heart J 1994;128:1209-20. http://dx.doi.org/10.1016/0002-8703(94)90752-8
15. 15. Weinstein L. Life-threatening complications of infective endocarditis and their management. Arch Intern Med 1986;146:953-7. http://dx.doi.org/10.1001/archinte.1986.00360170183025 PMid:3516105
16. 16. DeVeber G. In pursuit of evidence-based treatments for paediatric stroke: the UK and Chest guidelines. Lancet Neurol 2005;4:432-6. http://dx.doi.org/10.1016/S1474-4422(05)70120-4