A rare case of Cardiobacterium valvarum infective endocarditis in a pediatric patient with a history of truncus arteriosus repair
Hannah N. Kozlowski, Manal Tadros, Aaron Campigotto, Nouf AlSadoun, Valerie Waters, Lucina Tality, Phoenix Shum, Melissa Richard-GreenblattABSTRACT
Background
Infective endocarditis (IE) in children is rare, and in North America it is most often associated with congenital heart disease and Gram-positive organisms. Bacteria belonging to the HACEK group account for a small minority of cases;
Case Summary
A 6-year-old female with a history of repaired truncus arteriosus presented to the hospital with fever and polyuria. Urine cultures were negative; however, multiple sets of blood cultures grew a fastidious Gram-negative bacillus after 48 h. Echocardiography demonstrated an increased right ventricle-to-pulmonary artery conduit gradient and valvular thickening, raising concern for IE. Repeated identification attempts using Bruker Biotyper matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in multiple laboratories and the BD Phoenix automated identification system were unsuccessful. Definitive identification was achieved by 16S rRNA gene sequencing, confirming the organism as
Conclusion
This is the first reported case of pediatric IE caused by