Lactococcus garvieae endocarditis

Abstract

MOTS CLES Endocardite bacterienne ; Cirrhose hepatique ; A 64-year-old Taiwanese woman living in France was referred to the emergency department for recent onset fever. Past medical history included mitral valve replacement (Starr-Edwards prosthesis) in 1980 for rheumatoid mitral stenosis, pacemaker implantation in 2000, transient atrial fibrillation and chronic hepatitis C complicated by liver cirrhosis. Usual medications included propanolol, furosemide, warfarin and aldactone. Of note, she ate fresh seafood several times per week. On admission, her heart rate was 71 beats/minute, blood pressure was 130/70mmHg and body temperature was 38.9 ◦C. Physical examination revealed a mitral stenosis murmur. Haemoglobin concentration was 12 g/dL, white blood cell count was 14.4 g/L and platelet count was 79 g/L. C-reactive protein concentration was 18mg/L. Three blood cultures were positive for Gram-positive cocci; polymerase chain reaction identification confirmed Lactococcus garvieae, a microbial agent found in fresh seafood. Transoesophageal echocardiography revealed the presence of mobile infracentrimetric vegetation attached to mitral prosthesis, without any associated prosthesis dysfunction