Streptococcus pneumoniae endocarditis in a child: a case report

Abstract

Introduction: the incidence of invasive infections caused by pneumococcus (Streptococcus pneumoniae) has declined since generalized vaccination with pneumococcal conjugated vaccine, but it is still a prevalent pathogen in children. Amongst pneumococcal invasive infections, IE (infectious endocarditis) is rare, with an incidence between 1 and 7%.

Case report: We describe the case of a previously healthy 4 year old boy, who had received one dose of 10-valent pneumococcal conjugate vaccine who presents with fever, a new heart murmur and heart failure. Blood cultures were positive for penicillin susceptible pneumococcus. The transthoracic echocardiogram showed tricuspid and pulmonary valve vegetations. The patient received 4 weeks of antibiotic treatment for pneumococcal IE. He presented secondary valve damage that needed surgical treatment.

Conclusions: IE should be considered as a differential diagnosis of children presenting with fever and a newly diagnosed heart murmur, and pneumococcus as an etiologic agent in non hospitalized febrile patients with severe infections.