Upon visiting Thomas this morning, I was told that when his echocardiogram was reviewed by the cardio consultant last night, there is concern that there may be a vegetative growth in his heart, which would mean that he had endocarditis. One of my biggest fears.
His blood cultures are still showing growth of pantoea agglomerans despite being treated with strong antibiotics. So, they will repeat the echo on Monday to see if the suspected area of vegetation has shown any increase in size.
Anyone that has had heart surgery is at an increased risk of contracting endocarditis because heart surgery leaves scar issue.
A ‘normal’ persons heart has a smooth endocardium (lining inside heart) and therefore any bacterial blood infection would normally just circulate around, not sticking to anything. Where scar issue is present, bacteria and stick to it, particularly in the heart where there is a turbulent flow of blood, so through vessels.
Because Thomas has an absent pulmonary valve, which has a temporary patch over it to reduce the regurgitation of blood back into his ventricle, he has added scar tissue meaning that the bacteria could collect, colonise and cause infection. Endocarditis is a pretty serious infection if contracted in a healthy adult, so for an immunocompromised baby, it’s severe. I’m very worried about this one.
Other than this news, he’s had a settled day just trying to fight this latest infection. Vent weaning has stopped until he’s strong enough.