Pulmonary Artery and Pulmonic Valve Vegetations in a Young Pregnant Filipino with Patent Ductus Arteriosus
| Autor: | Charlene F. Agustin, Jose Donato A. Magno, Jezreel L. Taquiso, Valerie R. Ramiro, Stephanie Martha O. Obillos, Eric Oliver D. Sison |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Medical treatment Response to therapy business.industry Clinical course Case Report 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure lcsh:RC666-701 Ductus arteriosus Infective endocarditis medicine.artery Internal medicine Pulmonary artery medicine Cardiology 030212 general & internal medicine Transthoracic echocardiogram Risk factor Cardiology and Cardiovascular Medicine business |
| Zdroj: | Case Reports in Cardiology Case Reports in Cardiology, Vol 2019 (2019) |
| ISSN: | 2090-6412 2090-6404 |
| Popis: | Background. Infective endocarditis (IE) involving the pulmonic valve and/or the pulmonary artery is rare. An unrepaired patent ductus arteriosus (PDA) is a risk factor for IE. A previous IE is also a risk factor that predisposes to IE recurrence. Discriminating between IE recurrence and a persistence of a vegetation from a previously treated IE can be difficult. We present the case of a 19-year-old primigravid with an unrepaired PDA and a history of IE treated 7 years prior, with positive blood cultures and vegetations on the pulmonic valve and pulmonary artery seen on transthoracic echocardiogram (TTE). Methods and Results. On TTE, a small-sized PDA with a Qp : Qs of 1.18 and vegetations on the pulmonic valve and pulmonary artery were documented. Despite the paucity of symptoms, she was empirically treated as culture-negative IE and given 2 weeks of ceftriaxone. Repeat TTE done after 2 weeks only showed a slight decrease in the vegetation size. Due to the paucity of symptoms of infection, lack of growth of the vegetation, and absence of embolic events, the vegetations were deemed to be persistent remnants from the previous IE rather than a recurrent IE. She was advised surgical PDA closure and harvest of vegetations after delivery, but the patient did not consent. The rest of her perinatal course was uneventful. Conclusion. Persistence of vegetations despite successful medical treatment occurs in some cases and has not been reported to be associated with increased morbidity. Therefore, a follow-up of IE after treatment should be guided by the clinical course and response to therapy as well as the echocardiographic morphology of vegetations over time. |
| Databáze: | OpenAIRE |
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