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J Pediatr Intensive Care 2019; 08(03): 170-174
DOI: 10.1055/s-0038-1675583
Case Report
Georg Thieme Verlag KG Stuttgart · New York

A Case of Mitral Valve Endocarditis Complicated by Multiple Embolic Phenomena: Leaping from Adult Guidelines to Pediatric Critical Care Decisions

Tarif A. Choudhury
1   Department of Pediatrics, Division of Pediatric Cardiology and Pediatric Critical Care Medicine, Columbia University Medical Center, Morgan Stanley Children's Hospital of New York, New York, New York, United States
,
Jonathan N. Flyer
2   Department of Pediatrics, Division of Pediatric Cardiology, The Robert Larner, M.D. College of Medicine at The University of Vermont, University of Vermont Children's Hospital, Burlington, Vermont, United States
,
Henry M. Ushay
3   Department of Pediatrics, Division of Pediatric Critical Care Medicine, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, New York, United States
,
George Ofori-Amanfo
4   Department of Pediatrics, Division of Pediatric Critical Care Medicine, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, New York, United States
› Author Affiliations
Funding None.
Further Information

Publication History

03 August 2018

02 October 2018

Publication Date:
26 November 2018 (online)

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Abstract

Early surgical intervention for children with infective endocarditis (IE) and cerebrovascular sequelae has significant risks, resulting in practice variation amongst pediatric cardiologists, intensivists, and cardiothoracic surgeons. The limited pediatric consensus recommendations make decision making for practitioners challenging. The added risk of multiorgan dysfunction syndrome can make these decisions even more difficult. We present the case of a 14-year-old with IE and resultant multiorgan dysfunction syndrome including cerebrovascular complication, successfully treated by primary valve repair within the 1st week of diagnosis.

Keywords

Endocarditis - pediatric cardio-cardiothoracic surgery - multiorgan dysfunction syndrome

Author Contribution

Drs. T.A.C. and J.N.F conceptualized the case report, drafted the initial manuscript, reviewed, and revised the manuscript.


Drs. H.M.U. and G.O.A. conceptualized the case report, reviewed, and revised the manuscript for important intellectual content.


All the authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.