Acute Kingella kingae endocarditis with recurrent cerebral emboli in a child with mitral prolapse.

An 11-year-old girl had sudden onset of right hemiplegia and dysphasia with fever. Blood cultures grew Kingella kingae. Echocardiography showed a prolapsed mitral valve vegetation, which became larger during a prolonged course of antibiotics. After seven weeks of therapy, when surgery was being planned, the child deteriorated abruptly. A repeat echocardiogram showed that the vegetation had disappeared. Conservative medical management is usually inadequate in treating vegetations associated with bacterial endocarditis; surgery is advised.