Article in Japanese

Methicillin-sensitive Staphylococcus aureus -infective endocarditis after 10 months of atrial septal defect occluder implantation

Zuishin FURUTSUKI¹⁾, Taizo KUSANO¹⁾, Haruki MORI¹⁾, Taijiro WATANABE¹⁾, Shota YAMAMOTO¹⁾, Kouji HIGASHI²⁾, Ikuo HAGINO³⁾, Tadashi HOSHINO¹⁾

A 10-year-old girl, who had undergone percutaneous atrial septal defect (ASD) closure 10 months earlier, was referred and admitted to our hospital for poor general condition. Physical examination revealed Osler's nodule and Janeway's rash. Echocardiography revealed vegetation attached to the devices in the left and right atrial. Blood cultures revealed methicillin-sensitive Staphylococcus aureus and the patient leading to a diagnosis of infective endocarditis (IE). Since emboli were found in the brain, lungs, spleen, and kidneys, emergency closure device removal, vegetation removal, and ASD patch closure using autologous pericardium were performed. Endothelialization failure was observed in the excised closure device. The patient was treated postoperatively with antimicrobial agents for 6 weeks and recovered without sequelae.
Thirteen cases of IE associated with ASD closure devices implanted in childhood have been reported in literature, including the present case. Of these cases, 10 were caused by S. aureus, 11 were treated operatively, and 10 occurred ≧6 months after implantation, indicating that there remains a risk of developing IE long after ASD device closure.

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1）Department of infectious diseases, Chiba children’s hospital
2）Department of cardiology, Chiba children’s hospital
3）Department of cardiovascular surgery, Chiba children’s hospital

Key words	infective endocarditis, atrial septal defect, methicillin-sensitive Staphylococcus aureus, Figulla Flex Ⅱ occluder, endothelialization
Received	November 18, 2023
Accepted	December 16, 2023

36 (1)：33─41,2024