scholarly journals Corynebacterium propinquum: A Rare Cause of Prosthetic Valve Endocarditis

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Umair Jangda ◽  
Ankit Upadhyay ◽  
Farshad Bagheri ◽  
Nilesh R. Patel ◽  
Robert I. Mendelson
Keyword(s):  
Rheumatoid Arthritis ◽  
Chest Pain ◽  
Mitral Valve ◽  
Complete Resolution ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Blood Cultures ◽  
History Of ◽  
Systemic Infections ◽  
Compromised Patients

NondiphtheriaCorynebacteriumspecies are often dismissed as culture contaminants, but they have recently become increasingly recognized as pathologic organisms. We present the case of a 48-year-old male patient on chronic prednisone therapy for rheumatoid arthritis with a history of mitral valve replacement with prosthetic valve. He presented with fever, dizziness, dyspnea on exertion, intermittent chest pain, and palpitations. Transesophageal echocardiography revealed two medium-sized densities along the inner aspect of the sewing ring and one larger density along the atrial surface of the sewing ring consistent with vegetation. Two separate blood cultures grewCorynebacterium propinquum, which were sensitive to ceftriaxone but highly resistant to vancomycin and daptomycin. The patient completed a course of ceftriaxone and repeat TEE study and after 6 weeks demonstrated near complete resolution of the vegetation. To our knowledge, this case represents the first in the literature ofCorynebacterium propinquumcausing prosthetic valve endocarditis. The ability of these organisms to cause deep-seated systemic infections should be recognized, especially in immune-compromised patients.

scholarly journals Successful Resolution of Early-Onset Prosthetic Valve Endocarditis Associated With Extended Spectrum β-Lactamases Producing Escherichia coli With Medical Management

2020 ◽  
Vol 8 ◽  
pp. 232470962096533
Author(s):  
Umaima Dhamrah ◽  
Keely Johnson ◽  
Aisha Amin ◽  
Maurice Policar
Keyword(s):  
Escherichia Coli ◽  
Mitral Valve ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Blood Cultures ◽  
Extended Spectrum ◽  
Successful Resolution ◽  
History Of ◽  
Valve Placement

A 74-year-old male with a recent bioprosthetic mitral valve placement presented with dyspnea, chills, and palpitations. Blood cultures on admission grew extended spectrum β-lactamase Escherichia coli. Transthoracic echocardiogram and transesophageal echocardiography were negative for valvular vegetations, but given the recent history of mitral valve replacement and difficulty visualizing valvular vegetations in prosthetic valve, we initiated treatment of our patient with antibiotics for 6 weeks. Repeat blood cultures showed clearance of the organism and on follow-up, and the patient had no signs of recurrence of infection.

scholarly journals Prosthetic valve endocarditis presenting as meningoencephalitis complicated by pseudo-aneurysms in a remote Aboriginal healthcare setting in Australia: a case report

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Anna Louise Watson ◽  
Gregory Rice ◽  
Tony Hieu Vo ◽  
Nadarajah Kangaharan
Keyword(s):  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Healthcare Setting ◽  
Blood Cultures ◽  
Fatal Complication ◽  
Optimal Care ◽  
Australian Aboriginal ◽  
Valvular Surgery ◽  
Case Summary ◽  
History Of

Abstract Background The Australian Aboriginal population has a high burden of cardiac conditions predisposing patients to infective endocarditis. Pseudo-aneurysms are a rare and potentially fatal complication of both prior valvular surgery and endocarditis. Case summary A 31-year-old female with a history of bicuspid aortic valve requiring valve replacement presented with meningoencephalitis. Transoesophageal echo and positive blood cultures for Staphylococcus aureus confirmed prosthetic valve endocarditis (PVE). Aortic root mycotic pseudo-aneurysms developed during antimicrobial therapy and two large pseudo-aneurysms remain post-redo valve, root and arch replacement. Discussion Complications associated with PVE are common, especially due to S. aureus. Redo cardiac surgery is high risk, percutaneous treatments may be technically difficult due to altered post-operative anatomy, and medication adherence issues and lack of healthcare engagement further compromise optimal care in this patient population.

scholarly journals Corynebacterium CDC group G native and prosthetic valve endocarditis

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Adil Sattar ◽  
Siegfried Yu ◽  
Janak Koirala
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Mitral Valve Regurgitation ◽  
Venous Access ◽  
High Grade Fever ◽  
Access Port ◽  
First Case ◽  
Life Threatening ◽  
History Of

We report the first case of native and recurrent prosthetic valve endocarditis with <em>Corynebacterium</em> CDC group G, a rarely reported cause of infective endocarditis (IE). Previously, there have been only two cases reported for prosthetic valve IE caused by these organisms. A 69-year-old female with a known history of mitral valve regurgitation presented with a 3-day history of high-grade fever, pleuritic chest pain and cough. Echocardiography confirmed findings of mitral valve thickening consistent with endocarditis, which subsequently progressed to become large and mobile vegetations. Both sets of blood cultures taken on admission were positive for <em>Corynebacterium</em> CDC group G. Despite removal of a long-term venous access port, the patient’s presumed source of line associated bacteremia, mitral valve replacement, and aggressive antibiotic therapy, the patient had recurrence of vegetations on the prosthetic valve. She underwent replacement of her prosthetic mitral valve in the subsequent 2 weeks, before she progressed to disseminated intravascular coagulation and expired. Although they are typically considered contaminants, corynebacteria, in the appropriate clinical setting, should be recognized, identified, and treated as potentially life-threatening infections, particularly in the case of line-associated bacteremias, and native and prosthetic valve endocarditis.

scholarly journals Staphylococcus lugdunensisEndocarditis Complicated by Embolism in an 18-Year-Old Woman with Mitral Valve Prolapse

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Rosaria Pecoraro ◽  
Antonino Tuttolomondo ◽  
Gaspare Parrinello ◽  
Antonio Pinto ◽  
Giuseppe Licata
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Common Iliac Artery ◽  
Antibiotic Sensitivity ◽  
Prosthetic Valve Endocarditis ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Staphylococcus Lugdunensis ◽  
Mitral Valve Leaflet ◽  
History Of

Staphylococcus lugdunensisis a coagulase-negativestaphylococcus(CNS). It is a major cause of prosthetic valve endocarditis; mitral valve prolapse (MVP) has emerged as a prominent predisposing structural cardiac abnormality. We describe a case ofStaphylococcus lugdunensisendocarditis in an 18-year-old woman with preexisting mitral valve prolapse complaining of fever, a one-month history of continuous-remittent fever ( 38.6°C). The transthoracic echocardiogram revealed large vegetation on the anterior mitral valve leaflet flopping from the atrial side to the ventricular side. Five sets of blood cultures were positive for coagulase-negative staphylococci. During hospitalization, after two weeks of antibiotic therapy, the patient complained of sudden pain in her right leg associated with numbness. Lower limb arterial Doppler ultrasound showed an arterial thrombosis of right common iliac artery. Transfemoral iliac embolectomy was promptly performed and on septic embolusS. lugdunensiswith the same antibiotic sensitivity and the same MIC values was again isolated. Our patient underwent cardiac surgery: triangular resection of the A2 with removal of infected tissue including vegetation. Our case is an example of infective endocarditis byS. lugdunensison native mitral valve in a young woman of 18 with anamnesis valve prolapse.

scholarly journals 1646 Complicated aortic prosthetic valve endocarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Do Lago Palacio Estrela ◽  
M G Paiva ◽  
R L Ferreira ◽  
A S L Gazola ◽  
P S C Pedreira ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Prolonged Mechanical Ventilation ◽  
Prosthetic Valve Endocarditis ◽  
Blood Cultures ◽  
Oral Antibiotic ◽  
Heart Team ◽  
Mechanical Prosthesis ◽  
Aortic Prosthesis ◽  
18F Fdg

Abstract Introduction Prosthetic valve endocarditis (PVE) occurs in 1 to 3% of cases at 1 year and 3 to 9% at 5 years postoperative (PO) with 40% mortality. Clinical complications, uncontrolled infection and agents such as staphylococci and fungi indicate the need for surgery. Recent trial with stable patients (26.7% PVE), oral antibiotic therapy (ATB) proved to be as effect as intravenous antibiotic. However, in complicated cases, prolonged clinical treatment still an exception. Case Report ANFJ, male, 45 years old, aortic valve replacement by mechanical prosthesis in 2015, was hospitalized in Jun/18 with right front-temporal-parietal cerebral hemorrhage and sub febrile for 1 week. Transthoracic echocardiogram (TTE) showed pseudoaneurysm of the mitral valve anterior leaflet with 4+ regurgitation and aortic metallic prosthesis without dysfunction, but transesophageal echocardiogram (TEE) disclosed periprosthetic abscess. Empirical ATB was started until blood cultures yielded S. Agalactiae. After 3 weeks with ceftriaxone, patient persisted sub febrile, high CRP, pulmonary congestion and a new TEE showed mobile aortic prosthesis, fistula and periaortic regurgitation 4+. Urgent surgery was carried out at the same day for abscess drainage and replacement of prosthetic valve by biological aortic prosthesis but without mitral valve approach. Immediate PO underwent with hemodynamic instability, prolonged mechanical ventilation, pleural empyema, acute renal failure requiring dialysis and persistence of fever. Two weeks after surgery, TTE demonstrated new periprosthetic abscess with multiple collections along the ascending aorta. Reassessed by heart team and reoperation was contraindicated due to poor clinical conditions. Patient received parenteral broad-spectrum antibiotic evolving with clinical stabilization, normalization of inflammatory tests becoming afebrile. Aortic angiotomography in Aug/18 showed a periaortic collection of 3.0X2.0X1.9cm and contrast extravasation. New TEE in Aug/18 showed periprosthetic abscess and discrete aortic-right atrium fistula (2+). Maintained ATB until D42, persisting afebrile, negative blood cultures, normal leucogram and CRP. Considered inoperable, he was discharged on Sep/18. After 30 days, patient was stable, negative blood cultures however with worsening ESR (2 -&gt; 99mm/h) and CRP (0.5 -&gt; 15mg/dl). He performed ETT and 18F-FDG PET/CT on Nov/18 with persistence of abscess, fistula and high increase 18F-FDG uptake. Heart team again opted for prolonged oral ATB with amoxicillin 3.0gr/day. Re-evaluated on Dec/18 with laboratory normalization and good clinical evolution until last appointment on April/19 under oral antibiotic. Conclusion Reoperation of PVE improves prognosis, however in some cases where surgical risk is prohibitive, prolonged ATB may be the only option to control infecction or as a bridge for eventual heart transplantation. Abstract 1646 Figure.

scholarly journals Left Ventricular Pseudoaneurysm Repair after Mitral Valve Re-replacement for Prosthetic Valve Endocarditis

2018 ◽  
Vol 47 (4) ◽  
pp. 166-169
Author(s):  
Daisuke Yano ◽  
Fumiaki Kuwabara ◽  
Shinji Yamada ◽  
Shinichi Ashida ◽  
Yuichi Hirate
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Left Ventricular ◽  
Left Ventricular Pseudoaneurysm

Abstract 494: Mitral to Meninges: Aspergillus Endocarditis With Septic Emboli

2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Christopher T Smith ◽  
Dantwan Smith ◽  
Waqaar Arshad
Keyword(s):  
Mitral Valve ◽  
Fungal Infections ◽  
Early Recognition ◽  
Elevated Serum ◽  
Blood Cultures ◽  
Septic Emboli ◽  
Chronic Pancreatitis Patient ◽  
Fungal Endocarditis ◽  
Tertiary Center ◽  
History Of

Introduction: Fungal endocarditis comprises less than 2% of infective endocarditis, with Aspergillus causing less than 28% of fungal endocarditis. Fungal endocarditis should be suspected in immunocompromised patients with persistent fevers, negative blood cultures, and vegetation on echocardiography. Invasive Aspergillus can affect any organ, but typically begins in the respiratory tract. Mortality rates climb to 90% with signs of hematogenous spread, such as cerebral abscesses. Case Presentation: Patient is a 53-year-old female with a past medical history of Sweet syndrome and chronic pancreatitis. Patient was admitted for persistent fevers and confusion. Patient was tachycardic but normotensive with a temperature of 102.5 F. Labs included significantly elevated serum LDH and Beta-D-Glucan. Blood cultures remained negative. Lumbar puncture cultures were negative; CSF cytology revealed pleocytosis with positive Aspergillus galactomannan serum antigen. Head MRI revealed multiple peripherally enhancing supratentorial lesions and intracranial abscesses (largest 8.4 mm) with ventriculitis of lateral ventricles, right greater than left. Transesophageal Echocardiogram (TEE) revealed mitral valve vegetation at A2 segment, no surrounding perivalvular abscess, minimal mitral regurgitation (MR). Management: Antibiotics were discontinued and patient was counseled on avoiding glucocorticoids. Patient was transferred to large tertiary center for Neurosurgery evaluation but was not candidate for biopsy/aspiration of the ring-enhancing lesions per Neurosurgery. Cardiothoracic Surgery was also consulted and patient was not a candidate for mitral valve replacement due to small size of vegetation without abscess and only mild MR. Voriconazole was continued and patient ultimately demonstrated a slow improvement in her strength and mental status over the next 6 months. Discussion: Mitral endocarditis from Aspergillus is rare but has a very high mortality rate. This case illustrates the importance of early recognition of systemic fungal infections in the setting of immunosuppression. Glucocorticoids and broad-spectrum antibiotics placed this patient at elevated risk for invasive Aspergillosis, which led to mitral endocarditis and subsequent cerebral abscesses from septic emboli.

scholarly journals Tricuspid valve infective endocarditis in a non-IVDU patient with atopic dermatitis

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Heerani Woodun ◽  
Sarah Bouayyad ◽  
Sura Sahib ◽  
Nadir Elamin ◽  
Steven Hunter ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Intravenous Drug User ◽  
Blood Cultures ◽  
Topical Steroids ◽  
Foramen Ovale ◽  
History Of ◽  
The Right ◽  
Systemic Infections

Abstract A 29-year-old male, with chronic atopic dermatitis (AD), presented with a 2-week history of fatigue, pyrexia and weight loss. Examination showed eczematous patches with lichenified papules, erosions on the right shin and a new murmur. Blood cultures isolated methicillin-sensitive Staphylococcus aureus. Transthoracic echocardiography showed vegetation on the tricuspid valve (TV) that was adherent to the septal leaflet. He was treated for infective endocarditis, attributed to poorly controlled AD, with intravenous Flucloxacillin. Due to ongoing sepsis and pulmonary septic emboli, Clindamycin was added. He underwent TV repair; the septal leaflet was excised, and the remnant two leaflets were brought together with a ring. His patent foramen ovale was closed. His skin was treated with topical steroids and emollients. Right-sided endocarditis of an intact TV is uncommon in a non-intravenous drug user. Therefore, this novel case portrays the importance of aggressively managing AD as it is a risk factor for significant systemic infections.

scholarly journals Rat Bite Fever Resembling Rheumatoid Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ripa Akter ◽  
Paul Boland ◽  
Peter Daley ◽  
Proton Rahman ◽  
Nayef Al Ghanim
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Presentation ◽  
Blood Cultures ◽  
Zoonotic Infection ◽  
Presumptive Diagnosis ◽  
Rat Bite Fever ◽  
Rare Manifestation ◽  
History Of ◽  
High Index Of Suspicion ◽  
Culture Positive

Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.

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