P448Infective endocarditis in patent ductus arteriosus by bartonella sp: case report and literature review

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Case report: APS, 19 years, female, outpatients with a diagnosis of patent ductus arteriosus in planning surgical correction sought emergency room presenting episodes of fever measured 2 weeks ago, asthenia and fatigue. Additional research showed pancytopenia and hepatosplenomegaly. Prompted transthoracic echocardiography showing orifice of the ductus arteriosus thicked image hiperrefringente, mobile, looks filamentous pedunculated measuring 13 mm in length, the topography of the ductus arteriosus, pulmonary attached to the end. Requested three pairs of blood cultures without detectable bacterial growth. Patient admitted for investigation and treatment of infective endarteritis probable subacute seronegative blood channel, and also request surveys by indirect immunofluorescence for Bartonella sp, with positive results. Patient admitted for treatment with antibiotics and surgery scheduled for correction of patent ductus arteriosus, and started intravenous penicillin and gentamicin. During admission had septic symptomatic pulmonary embolization, followed by emergency surgery for correction of patent ductus arteriosus. Favorable outcome after high end drug treatment for 28 days.

Discussion: Bartonella sp is a common cause of infectious endocarditis seronegative, with few reports in the literature. However, there are no reports in the literature National endarterites ductus arteriosus caused by such bacteria. Since this diagnosis is considered difficult at the beginning of the investigation, it should search request Bartonella sp in all cases of infective endocarditis and endarteritis in patent ductus ateriosus with negative blood cultures, since the prevalence of this microorganism has been increasing in Brazil.

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