The diagnosis of aortic root abscess by cross-sectional echocardiography

Endocardial abscesses in children: case report and review of the literature

The rarity of perivalvular abscesses arising as a complication of bacterial endocarditis in the pediatric population limits its recognition and awareness of its often malignant course. The diagnosis depends on a combination of clinical criteria, including persistent fever and bacteremia, the presence of an atrioventricular block and persistent embolic phenomenon, and transthoracic or transesophageal echocardiographic confirmation. Because of the infrequency of perivalvular abscesses in children, there is no consensus on a treatment strategy. Early detection and intervention with antibiotics and surgical debridement are recommended to decrease the morbidity and mortality associated with this disease. A case of a 14-year-old boy with an aortic root abscess is presented, along with review of other cases reported in the last 20 years in children in relation to risk factors, clinical features, diagnosis, therapy, and mortality.

Persistent root abscess after emergency repair with an aortic homograft

A fifty eight year old man with Marfan's syndrome and an aortic composite graft with a Björk-Shiley mechanical prosthesis presented with a large aortic root abscess caused by Staphylococcus aureus endocarditis. Despite extensive surgical debridement and implantation of an aortic homograft as a composite graft, early postoperative transoesophageal echocardiography continued to demonstrate a large aortic root abscess and the patient died in a septic shock.