scholarly journals Infective endocarditis caused by Capnocytophaga canimorsus; a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jun Sakai ◽  
Kazuhito Imanaka ◽  
Masahiro Kodana ◽  
Kana Ohgane ◽  
Susumu Sekine ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Dna Sequencing ◽  
Extended Period ◽  
Visual Disturbance ◽  
Drug Susceptibility ◽  
Blood Cultures ◽  
Capnocytophaga Canimorsus ◽  
Adequate Treatment ◽  
Disk Diffusion Test

Abstract Background Capnocytophaga canimorsus is a gram-negative bacterium and an oral commensal in dogs and cats, but occasionally causes serious infections in humans. Septicemia is one of the most fulminant forms, but diagnosis of C. canimorsus infection is often difficult mainly because of its very slow growth. C. canimorsus infective endocarditis (IE) is rare and is poorly understood. Since quite a few strains produce β-lactamase, antimicrobial susceptibility is pivotal information for adequate treatment. We herein report a case with C. canimorsus IE and the results of drug susceptibility test. Case presentation A 46-year-old man had a dog bite in his left hand 3 months previously. The patient was referred to our hospital for fever (body temperature > 38 °C), visual disturbance, and dyspnea. Echocardiography showed aortic valve regurgitation and vegetation on the leaflets. IE was diagnosed, and we initially administered cefazolin and gentamycin assuming frequently encountered microorganisms and the patient underwent aortic valve replacement. C. canimorsus was detected in the aortic valve lesion and blood cultures. It was also identified by 16S ribosome DNA sequencing. Ceftriaxone were started and continued because disk diffusion test revealed the isolate was negative for β-lactamase and this case had cerebral symptoms. The patient successfully completed antibiotic treatment following surgery. Conclusions We diagnosed C. canimorsus sepsis and IE by extended-period blood cultures and 16S ribosome DNA sequencing by polymerase chain reaction, and successfully identified its drug susceptibility.

Infective endocarditis

2020 ◽  
pp. 163-176
Author(s):  
Salim Jivanji ◽  
Rubya Adamji ◽  
Michael Rigby
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Oral Hygiene ◽  
Aortic Valve Disease ◽  
Dental Hygiene ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Blood Cultures ◽  
Valve Disease ◽  
Symptoms And Signs

A young patient with previously repaired mixed aortic valve disease presented to his local hospital with symptoms and signs consistent with infective endocarditis. Following confirmation of Streptococcus viridans in his blood cultures, he underwent initial antibiotic treatment, followed by surgical resection of his right ventricular outflow tract vegetation. This chapter examines the difficulty in making a diagnosis of infective endocarditis, the devastating nature of its course, and the challenges in managing this condition. Finally, it explores the association of infective endocarditis with poor dental hygiene, the importance of promoting effective oral hygiene, and the evolving evidence in the use of antibiotic prophylaxis.

scholarly journals Infective Endocarditis Caused by Neisseria elongata on a Native Tricuspid Valve and Confirmed by DNA Sequencing

2014 ◽  
Vol 41 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Yeon Pyo Yoo ◽  
Ki-Woon Kang ◽  
Hyeon Soo Yoon ◽  
Seungmin Yoo ◽  
Myung-Shin Lee
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Therapy ◽  
Dna Sequencing ◽  
Tricuspid Valve ◽  
Unusual Case ◽  
Blood Cultures ◽  
Gram Negative ◽  
Dental Procedures ◽  
Oral Bacterium ◽  
Gerbode Defect

Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies.

Aortic and tricuspid valve infective endocarditis caused by Streptococcus suis

2019 ◽  
Vol 27 (9) ◽  
pp. 751-753
Author(s):  
Takao Miki ◽  
Satoshi Ohki ◽  
Tamiyuki Obayashi ◽  
Kiyomitsu Yasuhara ◽  
Shuichi Okonogi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Streptococcus Suis ◽  
Blood Cultures ◽  
Tricuspid Valve Replacement ◽  
Zoonotic Pathogen ◽  
Invasive Infections

Streptococcus suis is a zoonotic pathogen that causes invasive infections in humans. We report a case of aortic and tricuspid valve infective endocarditis caused by Streptococcus suis, which required cardiac surgery. The patient was a 53-year-old man with high fever and general fatigue for one month. He had been a pig farmer for 30 years. His blood cultures were positive for Streptococcus suis, and transthoracic echocardiography revealed aortic and tricuspid regurgitation with mobile vegetations adhering to the tricuspid valve. We performed aortic valve neo-cuspidization using autologous pericardium, and tricuspid valve replacement using a biological valve.

scholarly journals A case of aggressive aortic prosthetic valve endocarditis aggressive caused by Staphylococcus lugdunensis

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kazuhiro Yamazaki ◽  
Kenji Minakata ◽  
Kazuhisa Sakamoto ◽  
Jiro Sakai ◽  
Yujiro Ide ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Pathogenic Bacteria ◽  
Prosthetic Valve Endocarditis ◽  
Drug Susceptibility ◽  
Coagulase Negative Staphylococcus ◽  
Staphylococcus Lugdunensis

Abstract Background Staphylococcus lugdunensis is a coagulase-negative Staphylococcus species, which are weak pathogenic bacteria generally. However, the acute and severe pathogenicity of Staphylococcus lugdunensis infective endocarditis may be due to the rapid growth of large vegetation and consequent valve destruction. Case presentation The patient was an 81-year-old male who visited our hospital with chief complaints of low back pain and high fever. Four years before this visit, he had undergone aortic valve replacement for aortic regurgitation. He was found to be hypotensive. Although there is no heart murmur on auscultation and echocardiography revealed negative findings with aortic valve, a blood test showed increases in the white blood cell count and C-reactive protein concentration. On the next day, Gram-positive cocci were detected in a blood culture and echocardiography detected a large vegetation on the prosthetic valve with increased flow velocity. Therefore, he underwent redo aortic valve replacement emergently. Staphylococcus lugdunensis was identified in blood samples and vegetation culture. Consequently, the patient was treated with antibiotics for 5 weeks after the operation and discharged home. Conclusions We experienced rapidly progressive prosthetic valve endocarditis caused by Staphylococcus lugdunensis. Hence, Staphylococcus lugdunensis infective endocarditis requires aggressive treatment, and the pathogenicity of this coagulase-negative Staphylococcus with high drug susceptibility should not be underestimated.

Infective endocarditis by a rare and fastidious agent: Abiotrophia defectiva

2021 ◽  
Vol 14 (6) ◽  
pp. e241964
Author(s):  
Ana Margarida Mosca ◽  
Fenando Mané ◽  
Carla Marques Pires ◽  
Paulo Medeiros
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Blood Cultures ◽  
Surgical Aortic Valve Replacement ◽  
Delay In Diagnosis ◽  
Severe Aortic Regurgitation ◽  
Appropriate Treatment ◽  
Abiotrophia Defectiva ◽  
High Level ◽  
Prompt Diagnosis

Abiotrophia defectiva is a nutritional variant streptococcus, with affinity for endovascular structures that cannot be cultured on non-supplemented media, leading to a delay in diagnosis. This case describes a 36-year-old woman with a previously known bicuspid aortic valve that presented with asthenia, myalgias and anorexia with 2-month onset. On admission, we documented fever and a systolic murmur. Transthoracic echocardiography revealed an oscillating mass attached to the aortic valve. The patient was admitted with a possible diagnosis of infective endocarditis. Later, blood cultures were positive for A. defectiva. Due to severe aortic regurgitation and congestive heart failure, she underwent surgical aortic valve replacement. After 6 weeks of antimicrobial therapy, the patient experienced full recovery. Despite of its rarity, A. defectiva endocarditis is associated with significant morbidity with mortality and physicians must have a high level of suspicion to ensure a prompt diagnosis and provide the appropriate treatment.

scholarly journals A rare case of bacterial infective endocarditis caused by Streptococcus alactolyticus

2019 ◽  
Vol 3 (Issue 3) ◽  
pp. 109
Author(s):  
Nedim Cekmen ◽  
Oben Baysan ◽  
Emine Disbudak ◽  
Ceren Gunt
Keyword(s):  
Intensive Care Unit ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Rare Case ◽  
Artery Bypass ◽  
Previous History ◽  
Blood Cultures ◽  
Bypass Grafting ◽  
History Of

Background: Streptococcus alactolyticus is a rarely isolated bacterium, which classified under DNA cluster IV of the S. Bovis/S. equinus complex. Infections, especially infective endocarditis, caused by Strep. alactolyticus are very rare in humans. Case Report: We describe a case of Strepotoccocus alactolyticus bacteriemia complicated by infective endocarditis. A 64-year-old male with a previous history of coronary artery bypass grafting applied to our cardiology outpatient clinic with complaints of dyspnea, fever, confusion and an apical holosystolic murmur. He was admitted to the intensive care unit. Transthoracic and transesophageal echocardiography showed the presence vegetation on the aortic valve. S. alactolyticus was detected on serial blood cultures. The patient was first treated with intensive antimicrobial therapy, and then underwent mitral and aortic valve replacements with uneventful follow-up. Conclusion: Streptococcus alactolyticus infective endocarditis has only been reported previously in one patient. More information is certainly needed for diagnosis and treatment of patients infected with Streptococcus alactolyticus. Key words: Streptococcus alactolyticus, endocarditis

scholarly journals Aggregatibacter aphrophilus aortic valve infective endocarditis

Infectio ◽  
2017 ◽  
Vol 21 (2) ◽  
Author(s):  
Ana Luísa Broa ◽  
Inês Cruz ◽  
Carlos Cotrim ◽  
José Diogo
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Final Diagnosis ◽  
Blood Cultures ◽  
Lumbar Pain ◽  
Medical Procedures ◽  
Transthoracic Echocardiogram ◽  
Severe Aortic Regurgitation ◽  
Aggregatibacter Aphrophilus ◽  
Serious Infections

Nowadays, infective endocarditis remains a major cause of morbidity and mortality worldwide and there are concerns related to the increased number of infections associated with virulent agents and medical procedures. We present a case of a homeless man with unknown medical history, admitted for lumbar pain who became confused, hypotensive and tachycardic, evolving to severe sepsis. His initial investigation was also suggestive of acute myocardial infarction but the transthoracic echocardiogram revealed massive aortic valve vegetation with perivalvular abscess leading to severe aortic regurgitation. The patient died with the final diagnosis of infective endocarditis. Later on the blood cultures was identified Aggregatibacter aphrophilus, an HACEK group agent. This case confirms that, albeit the general favorable outcomes, there are cases of serious infections, especially if the diagnosis and treatment were late.

scholarly journals Capnocytophaga canimorsus and infective endocarditis—making a dog’s dinner of the aortic valve: a case report

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Anita Sri ◽  
Edward Droscher ◽  
Rodney De Palma
Keyword(s):  
Heart Failure ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
16S Rrna ◽  
Aortic Regurgitation ◽  
Close Contact ◽  
Young Male ◽  
Left Ventricular ◽  
Capnocytophaga Canimorsus ◽  
Culture Negative

Abstract Background Capnocytophaga canimorsus, a bacterium found in the oral cavities of healthy cats and dogs, is rarely reported as a cause of infective endocarditis. In this report we describe such a case in a young, male dog owner who presented acutely unwell in heart failure. Case summary A 47-year-old male presented with a subacute onset of fever, night sweats, weight loss, dyspnoea, and peripheral oedema. On clinical examination typical features of infective endocarditis, heart failure, and aortic regurgitation were found. The patient had no conventional risk factors for infective endocarditis but was a dog owner. Transthoracic echocardiography revealed vegetations on the right coronary and non-coronary cusps of the aortic valve causing severe eccentric aortic regurgitation and left ventricular dilatation. Initial blood cultures taken prior to the initiation of antimicrobial therapy showed no growth. The patient underwent aortic valve and root replacement and a 16S ribosomal RNA polymerase chain reaction (16S rRNA PCR) of the resected aortic valve tissue, using the additional primer set 785F/1175R targeting the V5–7 region of 16S rRNA, identified C. canimorsus. The patient was treated post-operatively with a 6-week course of meropenem and made a good recovery. Discussion Suspicion of C. canimorsus causing infective endocarditis should be considered in culture-negative infective endocarditis in individuals who have close contact with dogs or cats. Those who are immunocompetent can be susceptible to this infection and so this diagnosis should not be disregarded in healthy individuals. A 16S rRNA PCR can help identify this bacterium and should be used early in cases of culture-negative infective endocarditis.

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