Infective endocarditis (IE) is a rare complication of hypertrophic obstructive cardiomyopathy (HOCM). In adults, the incidence is about 5%.l Up to now, there have been only 43 cases reported in the and all of them were adults. This report describes a pediatric case of HOCM with IE and its cerebral complication.
CASE REPORT
An 11-year, 4-month-old girl was admitted with the chief complaints of generalized malaise, body weight loss, and cold sweating at night for 1 month. Past history revealed a heart murmur since early childhood. Physical examination showed a chronicly ill, pale, febrile girl. A Grade 3 pansystolic murmur and a Grade 2 diastolic murmur at the apex were audible. Another Grade 2 systolic ejection murmur was noted at left and right middle sternal border. The liver was 2 cm palpable below right costal margin, but the spleen was not palpable. An electrocardiogram showed left superior axis deviation, atrial and ventricular premature beats, intraventricular conduction disturbance, and left ventricular wall ischemia. Moderate cardiomegaly was noted on the chest X-ray. Abdominal echogram showed moderate amount of ascites.
M-mode and two-dimensional echocardiography showed a very thick interventricular septum (30 mm) disproportinate to the left ventricular