BACKGROUND: Infective endocarditis (IE) is a disease with a highly varied clinical picture. Spread of the infection to the pericardium from the infective endocardium is uncommon and IE involving all 4 cardiac valves is also a very rare occurrence, being more common in intravenous drug users (IVDU).

CASE REPORT: A 7-year-old boy had purulent pericarditis with infective endocarditis (IE) on all 4 cardiac valves and vegetation in the left ventricular and right atrial cavity. Culture of the pericardial fluid grew methicillin-resistant staphylococcus aureus (MRSA) sensitive to tigecycline. The child made a dramatic improvement with tigecycline treatment.

CONCLUSIONS: Aggressive management with pericardiocentesis and appropriate antibiotics can show remarkable clinical improvement. Tigecycline can be used safely and effectively as a life-saving drug in children.

Keywords: Anti-Bacterial Agents - therapeutic use, Child, Diagnosis, Differential, Echocardiography, Endocarditis, Bacterial - ultrasonography, Heart Valve Diseases - ultrasonography, Methicillin-Resistant Staphylococcus aureus - isolation & purification, Pericardiocentesis, Pericarditis - ultrasonography, Staphylococcal Infections - ultrasonography