Abstract
BackgroundCardiobacterium is a fastidious Gram-negative bacillus, and is a rare human pathogen in clinical settings. Herein, we describe a case of Cardiobacterium valvarum (C. valvarum) endocarditis with a rare complication of cerebral hemorrhage after mitral valve replacement (MVR), tricuspid valve prosthesis (TVP) and vegetation removal operation.Case presentationA 41-year-old woman who had a history of gingivitis developed into infective endocarditis due to the infection of C. valvarum. Then, she was hospitalized to receive MVR, TVP and vegetation removal operation. The indicators of patient tended to be normal until the abrupt cerebral hemorrhage occurred on day 15 after operation. This is the first well-described case of C. valvarum infection in China, and the first report of C. valvarum endocarditis with cerebral hemorrhage after MVR, TVP and vegetation removal operation worldwide.ConclusionsWe reported the first case of C. valvarum infection in China clinically, with a rare complication of cerebral hemorrhage after MVR, TVP and vegetation removal operation.
Highlights
Cardiobacterium is a fastidious Gram-negative bacillus, and is a rare human pathogen in clinical settings
We reported the first case of C. valvarum infection in China clinically, with a rare complication of cerebral hemorrhage after mitral valve replacement (MVR), tricuspid valve prosthesis (TVP) and vegetation removal operation
We present a case of infective endocarditis in a 41-year-old woman with mitral and tricuspid valve insufficiency
Summary
The genus Cardiobacterium encompasses two species, Cardiobacterium valvarum (C. valvarum) and Cardiobacterium hominis (C. hominis), with the latter one having higher infection prevalence. In order to control postoperative infection, meropenem of 1 g every 8 h were administrated to the patient for 10 days according to the susceptibility testing, and the increasing CRP level and elevated total white blood cell began to decrease to normal after 5 days of antibiotic treatments. Microscopy of the blood culture fluid identified small, rounded at both ends, Gram-negative, pleomorphic bacillus, often arranged in clusters (Fig. 2a, b). When it grows on 5% sheep blood agar as well as chocolate agar (BioMerieux, Marcy l’ Etoile, France) and incubating in ambient air supplemented with 5% CO2, the strains grew with gray white mycoderm after 24 h incubation and with glistening colonies of 0.5 mm after 4 days incubation. The C. valvarum strain showed high susceptibility to the listed antibiotics
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