Pulmonary artery vegetation in a pediatric patient with ventricular septal defect: a case report
Abstract: Infective
endocarditis (IE) is one of the congenital heart disease complications which is
frequently seen in ventricular septal defects (VSD). The Duke criteria are the
diagnostic criteria for IE. One of the major criteria is evidence of vegetation.
In VSD complicated with IE, vegetation is frequently found on the opening of
the defect, on the right ventricular side of the opening, on the tricuspid
valve, and less frequently it is found on the pulmonary valve. Vegetation found
in the lumen of pulmonary artery is rarely reported.
Case report: A 6 years old boy was consulted with congenital heart
disease. His chief complaint was shortness of breath. He came with unspecific
signs and symptoms with a history of frequent hospitalization due to pneumonia
and paleness. Chest X-ray showed enlargement of heart chambers. Transthoracic
echocardiography (TTE) revealed moderate size VSD and multiple vegetation on
right ventricle outflow tract, pulmonary artery valve, and inside the lumen of
main pulmonary artery and right pulmonary artery. The blood culture showed a
positive result for S. viridans. He was treated with parenteral antibiotic and
operated on later. We successfully performed evacuation of the vegetation and
VSD closure.
Conclusion: We reported a rare case of pulmonary artery vegetation in a
boy with moderate VSD that we treated with combination of parenteral antibiotic
followed by successful surgical vegetation evacuation and VSD closure.
Keywords: pulmonary artery;
vegetation; ventricular septal defect; infective endocarditis; surgery
Author: Haryo Aribowo
Jounal Code: jpkedokterangg170290
