, Volume 32, Issue 7, pp 1062-1064
Date: 26 Jul 2011

Formation of Ventricular Aneurysm After Endocarditis in a Child With Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteremia

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A 3-year-old previously healthy girl was admitted with fever, leg pain, and refusal to ambulate after minor leg trauma. Her blood culture results at admission were positive for methicillin-resistant Staphylococcus aureus (MRSA), and her inflammatory markers were elevated: erythrocyte sedimentation rate (ESR), 59; C-reactive protein (CRP), 25.

Broad-spectrum intravenous antibiotic coverage was initiated. Contrast-enhanced magnetic resonance imaging (MRI) showed extensive osteomyelitis of both lower extremities, bilateral hip septic arthritis, and multiple chest wall abscesses. On hospital day 9, a transthoracic echocardiogram exhibited vegetations near the tricuspid and mitral valves and coronary sinus (Fig. 1). On day 9, the first negative blood culture was obtained, and a follow-up echocardiogram on day 12 showed resolution of vegetations with concurrent improvement of inflammatory markers (ESR, 17).Fig. 1

Transthoracic echocardiographic four-chamber view showing vegetations (arrow) nea ...