Nonbacterial Thrombotic Endocarditis in Newborns

Abstract

Introduction: Nonbacterial thrombotic endocarditis, a rare disease in newborns, is characterized by the presence of endocardial vegetations, consisting of accumulations of platelets and fibrin, without the presence of microorganisms, which are not usually accompanied by an inflammatory reaction.

Objective: To describe the unusual presentation of nonbacterial thrombotic endocarditis in a newborn.

Case presentation: We present the case of a newborn, the result of a full-term delivery at 36.1 weeks, weighing 2850 grams and with an Apgar score of 8/9. In the first hour of life, respiratory distress occurred, so the infant was transferred to the Neonatology Service. He was placed on invasive mechanical ventilation and deep venous access was established. He progressed slowly, with lability to manipulation and hypoxemia. He developed pneumothorax and, despite the treatment applied, continued to progress unfavorably until his death two days after birth due to primary pulmonary hypertension, according to the clinical diagnosis. The autopsy revealed non-bacterial thrombotic endocarditis, a very rare condition in newborns, which caused extensive pulmonary thromboembolism of fine and medium branches, leading to the patient's death.

Conclusions: Thrombotic endocarditis is rarely seen in newborns. Accordingly, there are few publications referring to this condition. It is believed that studies of the manifestations observed in this case may contribute to improving the future diagnosis and treatment of this disease.