Abstract
Infective endocarditis (IE) caused by nutritionally variant Streptococci (NVS) is associated with high bacteriologic and treatment failure and mortality rates compared to endocarditis caused by other Streptococci. With automated blood culture systems, the rates of NVS-associated IE accounts for 5%-6% cases. We report a case of IE caused by NVS in an elderly female patient with no risk factors. The patient was successfully treated with combination antimicrobial therapy.
Highlights
Nutritionally variant Streptococci (NVS) are fastidious,pleomorphicGram-positivecocci belonging to the viridans group that grow as satellite colonies around other helper bacteria [1]
As NVS are associated with high rates of treatment failure and relapse and mortality in patients with infective endocarditis (IE), communication between the microbiologist and the clinician is of crucial importance for identification of these microorganisms early during the course of the infection before complications such as embolization or valvular failure occur
Gram-positive pleomorphic cocci arranged in pairs and short chains in a positive blood culture that fail or are very slow to grow on blood agar should alert the microbiologist to the possibility of NVS
Summary
Variant Streptococci (NVS) are fastidious,pleomorphicGram-positivecocci belonging to the viridans group that grow as satellite colonies around other helper bacteria [1]. They are the normal flora of oral cavity and are considered to be agents of endocarditis involving both native and prosthetic valves [2]. Three sets of blood cultures, BacT/Alert FAN aerobic and standard aerobic bottle per set (bioMerieux, Marcy l’Etoile, France) were submitted to the microbiology lab within 24 hours of admission and before antibiotic therapy with intravenous amikacin of 1 mg/kg body weight was initiated. Antibiotic susceptibility testing was performed with the mini API (bioMerieux, Marcy l’Etoile, France) using ATB strep panel. The patient made an uneventful recovery by the fourth week
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