Echocardiographic diagnosis of bacterial endocarditis of the mitral valve in a neonate
R. L. Bender, R. B. Jaffe, D. McCarthy and H. D. Ruttenberg
A full-term normal neonate had acute staphylococcal endocarditis. Serial
echocardiograms demonstrated abnormal echos in the region of the posterior
mitral valve leaflet and aortic outflow tract that were subsequently proved
to be a bacterial vegetation. This represents, we believe, the first case
reported of the echocardiographic diagnosis of bacterial endocarditis in a
neonate. There was progressive functional impairment of the mitral valve
despite appropriate antibiotic therapy. At necropsy, a 1-cm vegetation was
found attached to, and eroding through, the posterior mitral valve leaflet.
The remainder of the heart, including the mitral valve apparatus, was
normal. Endocarditis is a rare, but devastating, disease in a neonate, and
the echocardiogram is a safe noninvasive method of making an accurate
diagnosis and following the course of the disease.
