Staphylococcus lugdunensis Endocarditis in a Patient Being Treated for Pyelonephritis

Abstract

Staphylococcus lugdunensis
 Endocarditis in a Patient Being Treated for Pyelonephritis
 
 Christopher
 M Peake1, Nicholas Faure-Walker2, Elli DeMertzi2
 
 1St George’s University Hospital,
 Blackshaw Road, Tooting, London, UK
 
 2Kingston Hospital, Galsworthy Road,
 Kingston-upon-Thames, UK
 
  
 
 ABSTRACT
 
 A 35
 years old female with known chronic left pelvo-ureteric junction (PUJ)
 obstruction presented with recurrent pyrexia and left loin pain and was treated
 for pyelonephritis. She had a history of severe aortic valve (AV)
 regurgitation. After five days of broad spectrum antibiotics and a percutaneous
 nephrostomy, her fevers persisted. Staphylococcus
 lugdunensis was isolated from her blood culture and she was diagnosed with
 mitral valve endocarditis following an echocardiogram. She was transferred to a
 tertiary cardiothoracic unit where she underwent a mitral and aortic mechanical
 valve repair. After 6 weeks of intravenous antibiotic treatment she was
 discharged without signs of infection but with poor cardiac function. S. lugdunensis is a virulent organism
 which is thought to be underdiagnosed and is associated with aggressive and
 destructive endocarditis. An awareness of the organism as well as prompt
 diagnosis and treatment with effective multi-disciplinary management is needed
 to avoid substantial morbidity in these patients. 
 
 Whilst
 S. lugdunensis is known to cause
 invasive endocarditis, it has never been reported following pyelonephritis. The
 significance of this case is that despite receiving appropriate and timely
 treatment the patient was left with deteriorating cardiac function. This is an
 important reminder that this organism must be taken seriously when isolated in
 the context of infection. J Microbiol
 Infect Dis 2018; 8(1):37-40
 
 Keywords: Staphylococcus lugdunensis, endocarditis,
 pyelonephritis, heart valves, urinary tract