Endocarditis complicated by an aneurysm of the superior mesenteric artery

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie Vol. 21; no. 7; pp. 750 - 753
• Main Authors: Hatim, E G A, Hachimi, M-A, Madani, H, Atmani, N, Moutakillah, Y, Bamous, M, Abdou, A, Drissli, M, Aithoussa, M, Wahid, F-A, Boulahya, A, Haimer, C, Drissi Kamili, N
• Format: Journal Article
• Language: French
• Published: France 01.07.2014
• Subjects: Adolescent; Aneurysm, Infected - complications; Aneurysm, Infected - diagnosis; Aneurysm, Infected - microbiology; Aneurysm, Infected - therapy; Echocardiography; Endocarditis, Bacterial - complications; Endocarditis, Bacterial - therapy; Female; Humans; Magnetic Resonance Angiography; Mesenteric Artery, Superior - surgery; Viridans Streptococci - isolation & purification
• ISSN: 1769-664X
• DOI: 10.1016/j.arcped.2014.04.027

Infective endocarditis (IE) is a rare, polymorphic disease in children. Mycotic aneurysm is a rare condition that complicates about 2.5 to 10% of cases of endocarditis. It is responsible for significant morbidity and mortality [1,2]. Mycotic aneurysms are often asymptomatic, physical examination is poor, but the diagnosis should be considered with the triad including fever, abdominal pain, and abdominal mass beating. Abdominal ultrasound and computed tomography are the most useful for the identification of the aneurysmal mass. However, angiography is an interesting addition to confirm the diagnosis and implement a treatment procedure [3]. The treatment of SMA aneurysms is largely surgical. IE treatment is based on antibiotic therapy combined with surgical repair. We report the case of a 15-year-old patient, first operated for an SMA aneurysm complicating the course of IE, who secondarily underwent mitral valve repair. We review the epidemiology, diagnosis, and care principles of mycotic aneurysms of the SMA.