@Article{chd.12830,
AUTHOR = {Alessia Callegari, Barbara Burkhardt, Christa Relly, Walter Knirsch, Martin Christmann},
TITLE = {Ductus arteriosus‐associated infective endarteritis: Lessons from the past, future perspective},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {4},
PAGES = {671--677},
URL = {http://www.techscience.com/schd/v14n4/39296},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Since routine clinical use of antibiotics as well as surgical and catheter‐
based closure of a patent arterial duct (PDA), PDA‐associated infective endarteritis
(PDA‐IE) is rare but can still occur when the ductus is still open or as it closes. Thus,
clinicians should maintain a high index of concern for patients with unexplained fever.<br/>
<b>Methods:</b> We report on a PDA‐IE in a young infant shortly after potentially delayed
obliteration of a PDA. We discuss this case report by reviewing the literature in regard
to the pathogenesis (infection primary or secondary to PDA thrombus formation),
clinical (new heart murmur) and diagnostic findings (transthoracic echocardiography, 
total body MRI, laboratory findings), and clinical outcome during mid‐term follow‐up 
after successful antibiotic treatment.<br/>
<b>Results:</b> A 7‐week‐old term infant with Staphylococcus aureus sepsis and a new heart 
murmur was diagnosed with PDA‐IE by transthoracic echocardiography at the pul‐
monary artery end of an obliterated PDA. Broad diagnostic workup excluded other
reasons for sepsis. After 4 weeks of antibiotic treatment the vegetation reduced in
size and the infant recovered completely. A review of all cases of PDA‐IE (in pediatric
and adult patients) previously published was performed.<br/>
<b>Conclusion:</b> Nowadays, a PDA‐IE is an extremely rare, but still life‐threating condi‐
tion that may even affect patients with a nonpatent ductus arteriosus shortly after 
its obliteration and should be considered as infective complication in preterms, neo‐
nates, and small infants. Therefore, in septic neonates with bacteremia, transthoracic 
echocardiography may be integrated in the diagnostic workup, especially by fever 
without source and clinical signs of IE such as a new heart murmur.},
DOI = {10.1111/chd.12830}
}