Haemorrhagic stroke as the first presentation of undiagnosed infective endocarditis in an 8 year old boy

Infective endocarditis (IE) is uncommon in children with an incidence of around 0.6/100,000/year but causes a mortality of 11-20%. Only 7% of children having IE had neurological complications1. Ruptured mycotic aneurysm accounts for only 5% of neurological complications of IE. Rarely a ruptured mycotic aneurysm can be the first manifestation of IE. This catastrophic event is associated with 80% mortality. We present an 8 year old boy who presented with haemorrhagic stroke but was later confirmed to have features of mitral regurgitation along with mobile vegetations on anterior mitral leaflet.

Sri Lanka Journal of Child Health, 2015; 44(2): 114-116