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All Journal International Journal of Integrated Health Sciences
Charlotte Johanna Cool
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjajaran/Dr. Hasan Sadikin General Hospital Bandung
Health Professions

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Infective Endocarditis with Multiple Valvar Vegetation in Uncorrected Tetralogy Fallot: A Case Report of Rare Condition Charlotte Johanna Cool; Eliza Techa Fattima; Mega Febrianora; Aninka Saboe
International Journal of Integrated Health Sciences Vol 9, No 2 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v9n2.2165

Abstract

Objective: To describe a case of an adult patient with uncorrected Tetralogy of Fallot (TOF) who suffered from Infective Endocarditis (IE) that involved the tricuspid and aortic valves.Methods: On October 2019, a-twenty-year-old male with uncorrected TOF was admitted to the emergency department of Dr. Hasan Sadikin General Hospital with a chief complaint of fever. The echocardiography showed the presence of vegetation on the tricuspid valve and aortic valve. The patient was given empirical antibiotics therapy for IE treatment. The serial blood cultures did not yield any organism growth and the transthoracic echocardiography evaluation showed healed vegetation after 21 days of antibiotics treatment.Results: A high turbulence in small VSD and valvular stenosis, as found in TOF, can injure the endocardial surface. While bacterial adherence to the injured endocardial surface can cause IE, no specific criteria available for diagnosing IE in congenital heart disease (CHD) patients compared to other population. In CHD patients, it is necessary to consider the diagnosis of IE presenting with signs of infection or fever. Our patient was known to have uncorrected TOF and was admitted to the hospital with a chief complaint of fever. The uncorrected TOF was complicated by an unusual form of aggressive vegetation involving multiple valves.Conclusion: The incidence of IE in uncorrected TOF is around 4%. Patient is  advised to receive a corrective surgery for the cardiac anomaly. Surgical repair of CHD with no residual lesion reduces the risk of IE.
Unexpected Infective Endocarditis in Corrected Congenital Heart Disease: A Case Report Charlotte Johanna Cool; Rachmi Serulina; Aninka Saboe
International Journal of Integrated Health Sciences Vol 10, No 1 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v10n1.2166

Abstract

Objective: To describe patients with corrected Congenital Heart Disease (CHD) who experienced Infective Endocarditis (IE).Methods: Two cases of IE were observed in 2019. The first case involved a 36-year-old woman with previous percutaneous transcatheter perimembranous ventricular septal defect (VSD) closure four months before admission. Echocardiography showed vegetation at noncoronary cusps of the aortic valve. Patient received antibiotics for six weeks and underwent surgery for evacuation of vegetation and device, along with VSD closure with a cardiovascular patch (Gore-tex). The second case involved a 43-year-old woman with a history of surgical closure in secundum atrial septal defect (ASD) by pericardial patch two months before admission. Echocardiography showed vegetation at the tricuspid valve. Patient received antibiotics for four weeks and planned for surgery to evacuate vegetation.  Results: IE is one of the major complications in CHD, whether uncorrected, treated, or corrected. The risk of IE increased with an invasive procedure. Post closure IE is rare. Poor dental hygiene and immunocompromised also increased patient's risk to be exposed to IE as shown in the first patient who had dental caries and the second patient who was on methylprednisolone for post-surgical pericardial effusion treatment. Conclusion: The risk of IE increases with invasive procedures in CHD patients. Although the incidence of IE is quite rare, its possibility should become of a serious concern among physicians.
Co-Authors Aninka Saboe Eliza Techa Fattima Mega Febrianora Rachmi Serulina