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Kingella kingae endocarditis: A rare case of mitral valve perforation


1 Division of Pediatric Cardiovascular and Thoracic Surgery, BC Children's Hospital, Vancouver, Canada
2 Department of Pathology, University of British Columbia, Vancouver, Canada
3 Division of Pediatric Cardiology, BC Children's Hospital, Vancouver, Canada

Correspondence Address:
Anthony A Holmes
Pediatric Cardiovascular and Thoracic Surgery, BC Children's Hospital, Suite AB307, 4480 Oak Street, Vancouver, BC V6H 3V4
Canada
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.84664

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Year : 2011  |  Volume : 4  |  Issue : 2  |  Page : 210-212

 

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Kingella kingae , a HACEK (Haemophilus parainfluenzae, Aggregatibacter actinomycetemcomitans, Aggregatibacter aphrophilus, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae) organism, is a common resident of the upper airway in children; it has been associated with endocarditis in children with pre-existing heart conditions. This case report describes K. kingae endocarditis leading to valvular damage in a previously healthy 18-month-old child. Our patient developed a K. kingae bacteremia that was later complicated by meningitis, septic embolic stroke, and endocarditis of the mitral valve, leading to perforation of the posterolateral leaflet. The patient was initially treated conservatively with cefotaxime but, subsequently, required a mitral valve repair with a pericardial patch and annuloplasty. This report draws attention to the need for clinicians to be aware of the potentially serious complications of K. kingae infection in young children. If K. kingae infection is suspected then therapy should be initiated promptly with a β-lactam, followed by early echocardiographic assessment. This case also highlights the lack of specific guidelines available for K. kingae endocarditis.






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1 Division of Pediatric Cardiovascular and Thoracic Surgery, BC Children's Hospital, Vancouver, Canada
2 Department of Pathology, University of British Columbia, Vancouver, Canada
3 Division of Pediatric Cardiology, BC Children's Hospital, Vancouver, Canada

Correspondence Address:
Anthony A Holmes
Pediatric Cardiovascular and Thoracic Surgery, BC Children's Hospital, Suite AB307, 4480 Oak Street, Vancouver, BC V6H 3V4
Canada
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.84664

Rights and Permissions

Kingella kingae , a HACEK (Haemophilus parainfluenzae, Aggregatibacter actinomycetemcomitans, Aggregatibacter aphrophilus, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae) organism, is a common resident of the upper airway in children; it has been associated with endocarditis in children with pre-existing heart conditions. This case report describes K. kingae endocarditis leading to valvular damage in a previously healthy 18-month-old child. Our patient developed a K. kingae bacteremia that was later complicated by meningitis, septic embolic stroke, and endocarditis of the mitral valve, leading to perforation of the posterolateral leaflet. The patient was initially treated conservatively with cefotaxime but, subsequently, required a mitral valve repair with a pericardial patch and annuloplasty. This report draws attention to the need for clinicians to be aware of the potentially serious complications of K. kingae infection in young children. If K. kingae infection is suspected then therapy should be initiated promptly with a β-lactam, followed by early echocardiographic assessment. This case also highlights the lack of specific guidelines available for K. kingae endocarditis.






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