Purulent Pericarditis with Quadruple Valve Endocarditis

Patient: Male, 7 Final Diagnosis: Purulent pericarditis with quadruple valve endocarditis Symptoms: — Medication: (4S,4aS,5aR,12aS)-9-[2-(tert-butylamino)acetamido]-4,7 bis(dimethylamino)-1,4,4a,5,5a,6,11,12aoctahydro-3,10,12,12a-tetrahydroxy-1,11-dioxo-2 naphthacenecarboxamide Clinical Procedure: Pericardiocentisis Specialty: Cardiology OBJECTIVE: Rare disease BACKGROUND: Infective endocarditis (IE) is a disease with a highly varied clinical picture. Spread of the infection to the pericardium from the infective endocardium is uncommon and IE involving all 4 cardiac valves is also a very rare occurrence, being more common in intravenous drug users (IVDU). CASE REPORT: A 7-year-old boy had purulent pericarditis with infective endocarditis (IE) on all 4 cardiac valves and vegetation in the left ventricular and right atrial cavity. Culture of the pericardial fluid grew methicillin-resistant staphylococcus aureus (MRSA) sensitive to tigecycline. The child made a dramatic improvement with tigecycline treatment. CONCLUSIONS: Aggressive management with pericardiocentesis and appropriate antibiotics can show remarkable clinical improvement. Tigecycline can be used safely and effectively as a life-saving drug in children.