A Rare Case of Pediatric Infective Endocarditis Initially Presenting as Meningitis in a Previously Healthy Child.

Infective endocarditis (IE) is a rare but life-threatening condition in children, particularly in those without heart disease. Delayed diagnosis can lead to serious systemic complications. We report the case of an eight-year-old previously healthy girl, initially misdiagnosed with bacterial meningitis, who developed multiple septic embolic events (cerebral infarcts, digital gangrene, and splenic and renal infarction) despite being on antibiotic therapy. Repeat echocardiograms revealed mitral valve vegetation and an aortic root abscess. Blood cultures (aerobic and anaerobic) grew methicillin-sensitive Staphylococcus aureus (MSSA). She underwent successful surgical management via a modified Ross procedure, followed by a six-week course of intravenous (IV) flucloxacillin, resulting in full recovery. This case underscores the diagnostic challenges of pediatric IE in patients without known cardiac risk factors and highlights the critical role of serial imaging, multidisciplinary care, and early surgical intervention in achieving favorable outcomes.