ENDOCARDITIS AS THE FIRST PRESENTATION OF AIDS IN INFANCY

A two month old Ugandan boy underwent surgery for an obstructive right ventricular vegetation associated with disseminated Staphylococcus au reus infection. Both the child and his mother subsequently tested posi tive for HIV infection. Very little is know about the incidence of end ocarditis in paediatric patients with AIDS. To our knowledge this is t he first case reported of disseminated S aureus infection associated w ith endocarditis and an obstructing vegetation in an HIV positive infa nt with a structurally normal heart. The initial signs and symptoms fo r endocarditis were atypical, a reflection of the overwhelming infecti on in an immunocompromised patient. Severe infections may have an atyp ical presentation in immunosuppressed patients. AIDS needs to be consi dered in these patients, especially if they come from populations with endemic HIV infection.