Infective Endocarditis Caused By Streptococcus bovis Resistant to the Lethal Effect of Penicillin G

Abstract Background The Modified Duke criteria is an important structured schematic for the diagnosis of infective endocarditis (IE). Corynebacterium jeikeium is a rare cause of IE that is often resistant to standard IE anti-microbials. We present a case of C. jeikeium IE, fulfilling the Modified Duke pathological criteria. Case summary A 50-year-old male presented with left leg peripheral vascular disease with septic changes requiring amputation. Routine echocardiography post-amputation demonstrated severe aortic valve regurgitation with vegetations that required valve replacement. Two initial blood cultures from a single venepuncture showed Streptococcus mitis which was treated with penicillin G prior to surgery. Subsequent aortic valve tissue cultured C. jeikeium with suggestive IE histological valvular changes and was successfully treated on a prolonged course of vancomycin. Discussion This is the first C. jeikeium IE case diagnosed on heart valvular tissue culture and highlights the importance for the fulfilment of the Modified Duke criteria in diagnosing left-sided IE. Mixed infection IE is rare, and this case possibly represents an unmasking of resistant C. jeikeium IE following initial treatment of penicillin G.

Download Full-text

Infective Endocarditis Due to Corynebacterium Species: Clinical Features and Antibiotic Resistance

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab055 ◽

2021 ◽

Vol 8 (3) ◽

Author(s):

Anna Bläckberg ◽

Linn Falk ◽

Karl Oldberg ◽

Lars Olaison ◽

Magnus Rasmussen

Keyword(s):

Antibiotic Resistance ◽

Infective Endocarditis ◽

Prosthetic Valve Endocarditis ◽

Penicillin G ◽

Severe Condition ◽

Ionization Time ◽

Prosthetic Valves ◽

Corynebacterium Species ◽

Corynebacterium Striatum

Abstract Background Corynebacterium species are often dismissed as contaminants in blood cultures, but they can also cause infective endocarditis (IE), which is a severe condition. Antibiotic resistance of corynebacteria is increasing making treatment challenging. Reports on IE caused by Corynebacterium species are scarce and more knowledge is needed. Methods Cases of IE caused by Corynebacterium species were identified through the Swedish Registry of Infective Endocarditis. Isolates were collected for species redetermination by matrix-assisted laser desorption ionization-time of flight and for antibiotic susceptibility testing using Etests. Results Thirty episodes of IE due to Corynebacterium species were identified between 2008 and 2017. The median age of patients was 71 years (interquartile range, 60–76) and 77% were male. Corynebacterium striatum (n = 11) was the most common IE causing pathogen followed by Corynebacterium jeikeium (n = 5). Surgery was performed in 50% and in-hospital mortality rate was 13%. Patients with IE caused by Corynebacterium species were significantly more likely to have prosthetic valve endocarditis (70%), compared with patients with IE due to Staphylococcus aureus or non-beta-hemolytic streptococci (14% and 26%, respectively) (P < .0001). Vancomycin was active towards all Corynebacterium isolates, whereas resistance towards penicillin G was common. Conclusions Corynebacterium species cause IE, where prosthetic valves are mainly affected and surgery is often performed. Corynebacterium striatum is an important causative agent of IE within the genus. Antibiotic resistance of corynebacteria is relatively common but resistance towards vancomycin could not be detected in vitro.

Download Full-text

Synergy of imipenem or penicillin G and aminoglycosides against enterococci isolated from patients with infective endocarditis.

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.26.6.909 ◽

1984 ◽

Vol 26 (6) ◽

pp. 909-912 ◽

Cited By ~ 3

Author(s):

J A Indrelie ◽

W R Wilson ◽

J Y Matsumoto ◽

J E Geraci ◽

J A Washington

Keyword(s):

Infective Endocarditis ◽

Penicillin G

Download Full-text

Infective endocarditis due to penicillin-tolerant Streptococcus bovis

Diagnostic Microbiology and Infectious Disease ◽

10.1016/0732-8893(86)90119-7 ◽

1986 ◽

Vol 5 (2) ◽

pp. 171-176 ◽

Cited By ~ 3

Author(s):

Joan C. Fung ◽

Joseph J. Gadbaw ◽

Sam T. Donta ◽

Richard C. Tilton

Keyword(s):

Infective Endocarditis ◽

Streptococcus Bovis

Download Full-text

A severe infective endocarditis successfully treated with linezolid

Clinical Management Issues ◽

10.7175/cmi.v4i1.538 ◽

2010 ◽

Vol 4 (1) ◽

pp. 39-48

Author(s):

Graziano Antonio Minafra ◽

Donatella Concetta Cibelli ◽

Maria Pipino ◽

Vincenzo Dargenio ◽

Francesco Ventrella

Keyword(s):

Infective Endocarditis ◽

Soft Tissue ◽

Standard Therapy ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Multidrug Resistant ◽

Bacterial Endocarditis ◽

Soft Tissue Infections ◽

Streptococcus Bovis ◽

Gram Positive Cocci

Despite significant improvements in surgical and medical therapy, prosthetic valve endocarditis (PVE) is a diagnostic and therapeutic challenge and is often associated with a severe prognosis. We report a case of a 59-year-old woman, with PVE and bacterial endocarditis (Streptococcus bovis) successfully treated with linezolid. Linezolid is a bacteriostatic oxazolidinone antibiotic that has been proven to be effective for the treatment of patients with pneumonia, skin and soft tissue infections, and infections due to Gram-positive cocci. Linezolid is not yet recognised as a standard therapy for infective endocarditis, but its use becomes a necessity when infection is due to multidrug-resistant microorganisms.

Download Full-text

A study of clinical and etiological profile of infective endocarditis and its correlation with echocardiography in patients of rheumatic heart disease

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20174177 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1323

Author(s):

Achyut Sarkar ◽

Prashant Kumar ◽

Somnath Mukherjee ◽

Anurag Passi ◽

Jitendra Kumar Singh

Keyword(s):

Heart Disease ◽

Infective Endocarditis ◽

Blood Culture ◽

Rheumatic Heart Disease ◽

Local Population ◽

Penicillin G ◽

Sensitivity Pattern ◽

Moderate Anemia ◽

The Mean ◽

Rheumatic Heart

Background: This observational study was to determine the offending microorganisms and clinical profile of infective endocarditis in rheumatic heart disease patients in local population of Jharkhand, the response of disease to medical treatment and to evaluate the prognosis of the cases.Methods: 25 cases of Rheumatic heart disease, fulfilling the diagnostic criteria for infective endocarditis were studied prospectively with baseline investigations, blood culture and echocardiography and were treated with appropriate antibiotics.Results: In this study, the mean age observed was 26 year and male patient to female patient ratio was 3.16:1. Aortic valve was the commonest valve to be involved. Cardiac murmurs were present in all patients, splenomegaly was present in 56% of patients but peripheral signs of infective endocarditis were rare. Blood culture was positive in 28% of cases and staphylococcus aureus was the main organism isolated. 23 cases out of 25 cases studied showed vegetations on echocardiography mostly on aortic or mitral valve. In majority of patients (80%) injection Penicillin G and Gentamicin were started in standard recommended dose first on empirical basis but later on suitable antibiotics were started according to sensitivity pattern. Mortality was significantly high (20%).Conclusions: Fever and constitutional symptoms were the most common presentation. Mild to moderate anemia, leucocytosis, high ESR were very common but, peripheral signs were rarely observed in our study. Staphylococcus was the predominant etiological agent and treatment of endocarditis was more successful when suitable antibiotics were started after culture and sensitivity.

Download Full-text