"Burkholderia Septicaemia in a Child with Atrial Septal Defect and Pulmonary Hypertension: A Rare Clinical Association"

Abstract

Background:
Atrial Septal Defect (ASD) is a common congenital cardiac anomaly that often remains asymptomatic until adulthood. If undiagnosed or untreated, it can result in severe complications such as pulmonary arterial hypertension (PAH), which markedly worsens patient outcomes. Early detection and management are therefore essential to prevent irreversible pulmonary vascular changes.

Objectives:
To highlight the clinical presentation, diagnostic findings, and management of a pediatric patient with a large ostium secundum ASD complicated by moderate pulmonary arterial hypertension and secondary infection.

Methods:
A 7-year-old female presented with progressive dyspnea, fatigue, fever, and coryza. The patient had a history of recurrent lower respiratory tract infections. A 2D echocardiography revealed a large ostium secundum ASD (20×21 mm), mild right ventricular systolic dysfunction, mild mitral and tricuspid regurgitation, and moderate PAH. The patient was initiated on intravenous furosemide (Lasix), and strict input–output monitoring was maintained. Blood cultures were obtained due to persistent fever and systemic symptoms.

Results:
Blood culture grew Burkholderia cepacia and coagulase-negative Staphylococcus (CONS), confirming a secondary infection. The patient was treated with intravenous ceftazidime for 11 days, with close hemodynamic and respiratory monitoring in the pediatric intensive care unit. Clinical improvement was noted, and pulmonary pressures were stabilized with ongoing management.

Conclusions:
This case emphasizes the importance of early echocardiographic evaluation in children with recurrent respiratory infections to rule out underlying cardiac defects such as ASD. Timely medical management and infection control are crucial in preventing further deterioration and in improving the prognosis of patients with ASD-associated PAH.