Pasteurella multocida: An Uncommon Cause of Infective Endocarditis Affecting a Homograft Conduit in a Child

Abstract

Background: Disseminated septicemia and endocarditis are extremely rare complications of Pasteurella infection and are mainly seen in patients with associated major comorbidities. Clinical Description: A 13-year-old boy, who had undergone surgery for congenital heart disease in early childhood, presented with prolonged fever, gross hematuria, and oliguria. The child was found to be conscious and febrile, with tachycardia, pallor, and edema. There was a systolic murmur in the left upper sternal border with hepatosplenomegaly. Management and Outcome: Routine investigations revealed anemia, low serum albumin, and progressively worsening renal functions, with urinalysis showing significant proteinuria and red cells. Serial blood cultures showed growth of Pasteurella multocida. Echocardiography showed vegetation in conduit (homograft) connecting the right ventricle with the pulmonary artery. Despite intravenous antibiotics, the clinical condition did not improve, so the conduit was removed surgically, following which the child recovered. Conclusion: This case creates awareness regarding infective endocarditis in a child being caused by a rare organism P. multocida, involving a surgically created conduit. The case also highlights the importance of timely surgical removal of the source combined with a prolonged course of antibiotics in a successful recovery.

Keywords

• blood culture
• congenital heart disease
• glomerulonephritis