Abstract
Background. Aerococcus urinae is a rare causative pathogen of infective endocarditis that results in a high risk of embolic events. The mortality rate for A urinae endocarditis is high. Old age and underlying urologic conditions are the best-known risk factors for infection. Case Description. We report the clinical course of the disease in a 49-year-old man who presented symptoms of a urinary tract infection. A few days later, transthoracic echocardiography showed a conspicuous mitral valve with myxomatous alterations. Following the detection of a cerebral embolism with associated stroke symptoms, as well as at the beginning of cardiac failure, the emergency indication for the surgical treatment of mitral valve endocarditis was given. On the second day following the operation, circulatory collapse rapidly developed. Following an unsuccessful attempt at cardiopulmonary resuscitation, the patient died. Review of the Literature. From 1991 to 2017, 29 cases of A urinae–induced endocarditis have been described in PubMed and Medline. One or 2 new cases are published annually. We review all reported cases of A urinae endocarditis, with an emphasis on the predisposing factors, course, and outcomes of the disease. Conclusion. A urinae endocarditis is a rare disease primarily affecting elderly men with urinary tract pathologies and comorbidities. The course of the disease is severe, and the outcome is often fatal. A 16S rDNA polymerase chain reaction investigation of bacterial genome provides proof of the presence of A urinae. Because of the high risk of embolism, rapid treatment should focus on the diseased heart valve. Based on existing data and the experience gained from handling cases, treatment with β-lactam and aminoglycosides is recommended. It is also recommended that operative therapy take place as soon as possible.
Highlights
Aerococcus urinae is a gram-positive bacterium, a catalasenegative coccus
In the course of the 16S rDNA polymerase chain reaction (PCR) investigation of bacterial genome, it became clear that A urinae had without doubt been detected
Physicians and microbiologists should consider establishing whether endocarditis is present in patients when A urinae is isolated in blood
Summary
Aerococcus urinae is a gram-positive bacterium, a catalasenegative coccus. It was first described in the literature in the 1990s as a bacterium that causes urinary tract infections.[1]The organism is considered to be of low pathogenicity, and treatment may not always be required.[2,3] A urinae has been shown to cause invasive infections such as sepsis, urinary tract infection, and infective endocarditis (IE) in humans.[4,5]The mortality rate from A urinae endocarditis is high.A urinae can form biofilms on foreign materials and aggregate human platelets, which makes it potentially virulent.[4,6] Old age and underlying urologic conditions are the best-known risk factors for infection.[2,7,8]. Aerococcus urinae is a gram-positive bacterium, a catalasenegative coccus It was first described in the literature in the 1990s as a bacterium that causes urinary tract infections.[1]. Aerococcus urinae is a rare causative pathogen of infective endocarditis that results in a high risk of embolic events. We report the clinical course of the disease in a 49-year-old man who presented symptoms of a urinary tract infection. Following the detection of a cerebral embolism with associated stroke symptoms, as well as at the beginning of cardiac failure, the emergency indication for the surgical treatment of mitral valve endocarditis was given. We review all reported cases of A urinae endocarditis, with an emphasis on the predisposing factors, course, and outcomes of the disease. Because of the high risk of embolism, rapid treatment should focus on the diseased heart valve. It is recommended that operative therapy take place as soon as possible
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Investigative Medicine High Impact Case Reports
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
