Two cases and a review of Streptococcus pyogenes endocarditis in children

BMC Pediatrics

Shaun K Morris¹  Hilal Al-Hashami³  Danielle R Weidman² 

[1] Peter Gilligan Research Institute, Toronto, Canada;University of Toronto, Toronto, Canada;Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Canada

关键词: Toxic shock;    Group A Streptococcus;    Streptococcus pyogenes;    Endocarditis;   

Others  :  1137292
DOI  :  10.1186/1471-2431-14-227

 received in 2014-03-19, accepted in 2014-08-26,  发布年份 2014

【 摘 要 】

Background

Infective endocarditis is a rare diagnosis in pediatrics. Group A beta-hemolytic Streptococcus pyogenes is known to cause a range of type and severity of infections in childhood. However, S. pyogenes is a rarely described cause of endocarditis in children. This paper presents two cases of S. pyogenes endocarditis and the largest and most up-to-date review of cases previously reported in the literature.

Case presentation

Here we describe two pediatric cases of S. pyogenes endocarditis with associated toxic shock. Case 1 was a previously well Caucasian 6-year-old female who presented with sepsis. Case 2 was an 8-month-old South Asian female who presented with sepsis and pneumonia. We present a review of the literature since the beginning of the antibiotic era of this unusual cause of bacterial endocarditis in children.

Conclusion

In addition to the two cases presented here, a total of 13 children have been reported since 1940 with endocarditis caused by S. pyogenes for which clinical details are available. Although few cases exist, literature review reveals a high mortality rate (27%) and the majority of patients who recovered had residual morbidities. We emphasize the importance of considering a diagnosis of endocarditis in cases of S. pyogenes sepsis or toxic shock in order to ensure early diagnosis and timely treatment, which are necessary for good outcomes. This information is relevant to both general and subspecialty pediatricians, especially emergency room and infectious disease physicians.

【 授权许可】

   
2014 Weidman et al.; licensee BioMed Central Ltd.

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