METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS ENDOCARDITIS FOLLOWING PATCH CLOSURE OF A VENTRICULAR SEPTAL-DEFECT - REPORT OF A CASE

We report herein the case of a 5-month-old infant who, after developin g methicillin-resistant Staphylococcus aureus (MRSA) endocarditis foll owing patch closure of a ventricular septal defect (VSD), was successf ully treated by replacement of the Dacron patch with an autogenous per icardial patch. Initially, a large perimembranous VSD was repaired wit h a Dacron patch and after an uneventful recovery of 1 week, he began to spike intermittent fevers from 38-degrees-C to 39-degrees-C. Two bl ood cultures grew MRSA and a two-dimensional echocardiogram performed 16 days after surgery showed an irregular mass attached to the right v entricular aspect of the Dacron patch. At reoperation, a large vegetat ion attached to the Dacron patch was confirmed, but there was no patch dehiscence. Following removal of the patch, the VSD was repaired with an autogenous pericardial patch, soon after which the fever rapidly s ubsided. Imipenem, 125 mg every 6 h, and fosfomycin, 300 mg every 6 h, were administered for a total of 24 days after reoperation. The child remains well 12 months after his second operation.