ro13-9904 and Heart-Septal-Defects--Ventricular

Bacterial endocarditis secondary to jet lesions from congenital heart disease is not uncommon, and has been reported on numerous occasions in the literature. These cases usually involve one or more cardiac valves. Our case is that of isolated intracardiac right-sided mural infective endocarditis associated with ventricular septal defect. Importantly, this patient had preceding dental work treated with antibiotic prophylaxis. This case highlights bacteraemia secondary to dental instrumentation versus routine oral hygiene. His presentation was predominantly that of respiratory symptoms and sepsis, and he was culture negative throughout his admission. The lesion was detailed on echocardiography and transoesophageal echocardiography, and treated conservatively. He has subsequently been referred for VSD closure.

Topics: Amoxicillin; Anti-Bacterial Agents; Antibiotic Prophylaxis; Ceftriaxone; Denture, Partial; Echocardiography, Transesophageal; Endocarditis, Bacterial; Heart Septal Defects, Ventricular; Heart Ventricles; Humans; Male; Penicillin G; Young Adult

A 54-year-old female patient with a congenital ventricular septal defect (VSD) was admitted to the authors' hospital for an investigation of mild fever of four months' duration. Her history revealed pulmonary valve endocarditis contracted 18 years previously. Echocardiography revealed an echogenic mobile mass on the pulmonic valve that caused mild regurgitation, while blood cultures were positive for Streptococcus viridans. The patient was administered ceftriaxone and gentamycin, and had an uneventful clinical course. She was advised to undergo surgical closure of the VSD in order to avoid any recurrence of endocarditis.

Topics: Anti-Bacterial Agents; Ceftriaxone; Echocardiography, Transesophageal; Endocarditis, Bacterial; Female; Gentamicins; Heart Septal Defects, Ventricular; Humans; Middle Aged; Pulmonary Valve; Recurrence; Streptococcal Infections; Viridans Streptococci