Infective Endocarditis Caused by Methicillin-Resistant Staphylococcus epidermidis in the Infant of a Mother with Diabetes: A Case Report.

Abstract

Infective endocarditis (IE) is a rare but severe condition caused by microbial infection of the endocardium. It affects both adults and children with underlying conditions or immunosuppression, including infants of mothers with diabetes (IDMs). We report a case of IE caused by methicillin-resistant Staphylococcus epidermidis (MRSE) in a newborn IDM. A male infant was born at 38 weeks gestation, weighing 5,102 g. His mother had poorly-controlled type 2 diabetes, and the infant had asymmetric septal hypertrophy of the heart. He was admitted to our unit with severe hypoglycemia and respiratory distress necessitating treatment using an indwelling peripherally-inserted central catheter (PICC). The tip of the PICC was moved to the appropriate position because it was initially located in the patient's right ventricle. He was determined to have IE via a positive MRSE blood culture and vegetation in the right atrium. He was treated with vancomycin followed by surgery at 74 days of age to remove the vegetation. He recovered well and was discharged at 92 days of age. IDMs whose mothers have poorly-controlled diabetes may be at higher risk of IE, particularly if they have hemodynamic abnormalities and indwelling PICCs. However, further studies are warranted to confirm this hypothesis.