Infective endocarditis on a patent ductus arteriosus revealed by a ruptured pulmonary artery trunk aneurysm in the pericardium: a case report

TL;DR

A rare case of infective endocarditis on a patent ductus arteriosus led to a ruptured pulmonary artery aneurysm, requiring emergency surgery and recovery.

Contribution

This case report highlights the rare and severe complication of infective endocarditis on a patent ductus arteriosus with a ruptured aneurysm.

Findings

A 20-year-old female presented with endocarditis on a patent ductus arteriosus and a ruptured pulmonary artery aneurysm.

Emergency surgery and antibiotics led to successful recovery after a 4-week treatment.

Early diagnosis is crucial to prevent severe complications like aneurysm rupture in such cases.

Abstract

Infective endocarditis on a patent ductus arteriosus (PDA) is a rare but serious condition that can lead to life-threatening complications, such as mycotic aneurysms. We report a case of endocarditis on a PDA, complicated by multiple mycotic aneurysms, including a partially ruptured aneurysm of the pulmonary artery (PA) trunk.

A 20-year-old female presented with progressive dyspnoea, worsening over 48 h, accompanied by fever. Echocardiography revealed a large pericardial effusion with cardiac tamponade, necessitating the drainage of 500 mL of haemorrhagic fluid. Imaging studies revealed a false aneurysm of the PA trunk, with contrast extravasation into the pericardial space. Blood cultures and pericardial fluid cultures were positive for Staphylococcus aureus. Emergency surgery involved resection of the aneurysm, ligation of the PDA, and pericardial drainage. The patient recovered after 4 weeks of intravenous antibiotics and was discharged with good clinical and biological outcomes.

This case illustrates the importance of early diagnosis and management of infective endocarditis associated with congenital heart defects, as the delay can result in severe complications such as aneurysm rupture.

Figures