Rare Case Of Infective Endocarditis Research Articles

Rare Case of Infective Endocarditis Due to Gemella Morbillorum in Patient with Bicuspid Aortic Valve

Infective endocarditis caused by Gemella morbillorum is one of the rare causative microorganisms of endocarditis and only a few cases have been reported in the literature so far. We describe a case of Gemella morbillorum endocarditis in a 37-year-old Moroccan man who had a congenitally bicuspid aortic valve. He presented to our institution with a 1.5-month history of fever, and the onset of a motor deficit in the right hemibody one day prior to consultation. A transthoracic echocardiogram showed two large, echogenic and mobile vegetations (30×8 mm) with perforation of the left cusp and fistulized abscess of the anterior mitral leaflet measuring approximately 16x20mm. Blood cultures of the patient grew pan-sensitive Gemella morbillorum. The patient fulfilled the Duke’s criteria for infective endocarditis. The patient was successfully treated with antibiotics and aortic and mitral valves replacement.

Bacterial endocarditis caused by contact lens usage

A 17-year-old female was transferred to our hospital due to high fever, general fatigue, and dim eyesight. Three weeks before, she had used cosmetic colored contact lenses and then suffered from bloodshot eyes associated with dim eyesight. Intermittent fever and general fatigue were followed by eye symptoms. Echocardiography revealed moving vegetation on the posterior leaflet of the mitral valve associated with mild mitral valve regurgitation. There were no infectious sites in systemic examinations; thus, the cause of infective endocarditis was considered the infection due to contact lens usage. The patient initially received mitral valve plasty associated with the removal of infective sites. However, redo surgery was necessary 19 days later due to the relapse of infection, and the mitral valve was replaced by bioprosthesis. Traumatic injury of vessels due to inappropriate contact lens usage seemed to lead to systemic hematogenous infection and subsequent endocarditis. We report a rare case of infective endocarditis which was caused by contact lens usage.

Quest for a Unifying Diagnosis: Felty Syndrome?

Felty syndrome is a rare seropositive rheumatoid arthritis (RA), splenomegaly, and absolute neutropenia [1] occurring in less than 1% of patients with RA [2]. As the disease itself is asymptomatic, patients usually present with acute infection superimposed on a long-standing, erosive RA diagnosis [2]. Infective endocarditis is one of the most common life-threatening infectious syndromes [2]. We describe a rare case of infective endocarditis in a patient with a diagnosis of Felty syndrome.

Case Study: Abnormal Presentation of Infective Endocarditis With Streptococcus Canis and Chiari Network

Here we present a rare case of infective endocarditis (IE) with Streptococcus canis and Chiari network in an 85 year old female living with multiple dogs and open skin of lower extremity predisposing her to bacteremia. Underlying abnormalities of the cardiac chambers such as Chiari network predisposes to a higher incidence of bacterial seeding and causing IE. A Chiari network is usually asymptomatic and of no clinical significance but can worsen prognosis in IE. IE carries a significant morbidity and mortality burden and when diagnosed early can be a lifesaving diagnosis. Due to the wide range of complications, early diagnosis and treatment with targeted antimicrobial therapy and consideration of early surgical intervention are vital to the evaluation and treatment of IE. Though Staphylococci, Streptococci, Enterococci, HACEK organisms amount for the majority of IE, some atypical organisms including group G Streptococci such as S. canis have been reported to carry high mortality and hospitalization risk in patients with bacteremia. S. canis is a group G beta-hemolytic Streptococci which normally resides on the skin and mucosal surfaces of dogs. This Case Report shines light on the versatility of microorganisms that can cause IE in a patient with underling Chiari network, and the risk of morbidity and mortality with such species highlighting the importance of early diagnosis and treatment.

Abstract 13195: A Case of Ebstein Anomaly Diagnosed Following Tricuspid and Pulmonic Valve Infective Endocarditis in an Adult Patient

Background: We present a rare case of infective endocarditis (IE) involving both tricuspid (TV) and pulmonic valves (PV) in the setting of newly diagnosed Ebstein anomaly (EA) with isolated, small membranous VSD. Case: A 48 yo woman with no known medical history presented with two weeks of fever, flu-like symptoms, and dyspnea. Vitals showed fever, tachycardia, and tachypnea. Poor dentition, grade III systolic murmur, and S3 gallop were noted on physical exam. EKG showed sinus tachycardia and right bundle branch block. Laboratory studies showed leukocytosis and elevated CRP. A chest CT revealed bilateral lung infiltrates in a rounded configuration concerning for septic emboli. Blood cultures grew Streptococcus mitis , and IV antibiotics were initiated. TTE revealed 3.2cm apical displacement of the TV resulting in right ventricular atrialization, diagnostic for EA. TTE also found a 26x17mm vegetation on the septal and anterior leaflets of the TV with moderate tricuspid regurgitation and an 11x6mm vegetation on the PV, confirmed by TEE. Cardiac MRI also noted a focal aneurysm of the membranous interventricular septum with a hemodynamically insignificant shunt. Discussion: While interatrial communications are seen in a majority of EA patients (80-94% of cases), this patient presented solely with a small membranous VSD and absence of ASD and PFO. Moreover, this patient had no PDA to depend on for pulmonary flow. Remarkably, she had an asymptomatic course with EA until the development of endocarditis. It is believed the presence of an isolated VSD in this patient’s severe EA likely promoted forward pulmonic flow in an already inadequate right ventricle. Right-sided IE is itself rare (5-10% of cases) with isolated PV involvement being even rarer (2% of cases). This patient’s uncorrected EA with redundant TV and PV leaflet tissue likely contributed as a nidus for simultaneous infection of both valves.

Severe Arrhythmia Caused by Abscess Endocarditis on a Bicuspid Aortic Valve: Case Report and Literature Review

The incidence of infective endocarditis (IE) on the bicuspid valve is high with serious complications. Perivalvular extension is one of the most serious complications because it can be complicated by conduction disorders such as AV block or bundle branch block or rhythm disorders, often with a poor prognosis. We report a rare case of infective endocarditis in a bicuspid aortic valve complicated by perivalvular abscess and trifasicular block.

Infective Endocarditis With Secondary Headache: A Case Report

Secondary headache is a symptom of an underlying disease. Infective endocarditis (IE) is a serious infection of the heart tissue. Herein, we present a rare case of IE, with a secondary headache. The patient presented with persistent headache, fever of 39°C, myalgia, and painful erythema of the plantar surface of the foot. The headache progressively worsened over a few weeks. She was diagnosed with secondary headache, and sepsis was suspected. Blood culture revealed the presence of Streptococcus viridans, leading to a diagnosis of IE. Postoperatively, the patient recuperated without any complications. Headaches can be secondary to other conditions. Therefore, comprehensive assessment and accurate diagnosis are essential. Dentists must be aware that headache is a concomitant symptom of IE.

Infective endocarditis with Osler’s nodule in a patient with Osler’s disease: a case report and review of the literature

BackgroundHereditary hemorrhagic telangiectasia, also known as Osler–Weber–Rendu disease, induces arteriovenous malformations in visceral organs. Arteriovenous malformations increase the risk of severe infections and are a common complication associated with hemorrhagic telangiectasia. However, cases of endocarditis associated with hemorrhagic telangiectasia are rarely reported. Although hemorrhagic telangiectasia causes erythematous macules on the extremities, these macules are usually painless. We encountered a rare case of infective endocarditis in a patient with Osler–Weber–Rendu disease.Case presentationA 52-year-old Japanese woman who was diagnosed with hemorrhagic telangiectasia 5 years prior presented to our hospital with fever and muscular pain. She had erythematous nodules and tenderness on the finger, heel, and toe, suggestive of Osler’s nodes. A physical examination revealed tachycardia with a 3/6 pansystolic murmur. A transesophageal echocardiogram showed vegetations along the atrial side of the mitral valve and mild mitral regurgitation because of prolapse of the anterior commissure. Methicillin-sensitive Staphylococcus aureus was identified in the blood cultures. Detection of distinctive skin lesions, so-called Osler’s nodes, was the symptomatic key to early diagnosis, and the patient was treated without surgery. She was discharged with negative blood cultures after a 6-week intravenous antibiotic administration.ConclusionsOur report highlights the importance of considering the risk of extracerebral infections including endocarditis in hemorrhagic telangiectasia. This rare case effectively demonstrates the importance of proper diagnosis of skin lesions.

A rare case of infective endocarditis in a quadricuspid aortic valve caused by Gemella sanguinis

Infective endocarditis (IE) in patients with a quadricusp aortic valve (QAV) is a rare occurrence that has only been described nine times in English literature. Similar in rarity, IE by Gemella sanguinis has only been described ten times. It has never been described in a patient with QAV. We describe a case of Gemella sanguinis infective endocarditis of a quadricusp aortic valve in a patient in his 4th decade of life. His QAV was detected on pre-operative transesophageal echocardiogram and confirmed intra-operatively. The patient was managed with bioprosthetic aortic valve replacement and a 6-week course of intravenous antibiotics.

A Rare Case of Infective Endocarditis Complicated with a Cardiac Abscess Causing Heart Block

Individuals that have undergone cardiac surgery or heart valve replacement are at increased risk for developing Infective Endocarditis (IE). IE has numerous signs and symptoms as well as complications. However, an interesting and unique presentation of IE can be in an individual showing a complete heart block on EKG. A heart block from an IE will typically present with a cardiac abscess on Transesophageal Echocardiogram (TEE) and coronary Computed Tomography Angiography (CTA). This individual, with a past medical history of transcatheter aortic valve replacement in 2011, was found to have Enterococcus faecalis bacteremia and endocarditis. Soon after discovery of the infection, CTA of the coronaries showed a 7.6 × 4.6 × 2.5 cm loculated pericardial collection consistent of a cardiac abscess. Despite the initiation of antibiotic therapy, this gentleman with bacterial endocarditis had an increased risk of immediate mortality, due to the complete heart block and additional complications. High clinical suspicion and early intervention are warranted for cases of infective endocarditis.

A rare case of infective endocarditis due to Enterococcus faecium

A 48-year-old male, farmer by occupation with no prior comorbidities came with chief complaints of fever since 5 months, associated with loss of weight and loss of appetite. On general examination, pallor and clubbing were present. Blood pressures were 120/20 mmHg in both upper limbs and 200/60 mmHg in both lower limbs. Cardiovascular examination, on auscultation there was pansystolic murmur in mitral area radiating to axilla, holodiastolic murmur in aortic area. All routine blood investigations were done. Echocardiogram was suggestive of infective endocarditis of aortic valve with multiple thickened vegetations over aortic valve. Blood cultures grew Enterococcus faecium in two sets. The patient was treated with antibiotics according to culture sensitivity report. Patient improved clinically and was discharged.

Primary infective endocarditis with isolated involvement of the pulmonary valve not associated with drug addiction

Objective: to describe a rare case of infective endocarditis (IE) with isolated localization in the pulmonary valve (PV).Materials and methods. We observed primary IE with isolated localization in the PV in a 27-year-old female patient without risk factors of right-side IE.Results. The disease was caused by Streptococcus gordonii and proceeded acutely with typical signs of right-side IE: fever above 38 °С, chills, clinical picture of bilateral septic embolic abscess pneumonia, as well as secondary anemia, secondary thrombocytopenia, and glomerulonephritis. Echocardiography showed large vegetations in the PV prolapsing in the right ventricle and pulmonary artery.Conclusion. IE with localization in the PV should be suspected in patients with fever and clinical picture of septic embolic pneumonia in absence of other embolic situations.

Both-sided native valve infective endocarditis in a drug addict with incidental pneumoconiosis

Involvement of both right and left heart chambers with infective endocarditis is extremely rare. In this case report, we aimed to present a rare case of Infective endocarditis (IE) in an intravenous & inhalational drug misuse involving both cardiac chambers with incidental pneumoconiosis.

A Rare Case of Infective Endocarditis with Multiple Vegetations and Invasion of Papillary Muscle

Infective endocarditis (IE) is a life threatening infection of cardiac valves leading to high mortality, if it is not recognized earlier and promptly treated. Usually, IE affects single cardiac valve. Angry looking vegetations at multiple sites and vegetations invading the papillary muscles are rare. Such involvement is associated with even higher mortality. Here we present a case of Infective endocarditis with multiple vegetations involving mitral valve, aortic valve and papillary muscle of left ventricle with heart failure who was successfully treated with antibiotics and heart failure drugs and subsequently with double valve replacement. Patient was hemodynamically stable after surgery and is on regular follow-up.

Correction to: Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.

HomeCirculationVol. 134, No. 8Correction to: Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association Free AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessCorrectionPDF/EPUBCorrection to: Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association Originally published23 Aug 2016https://doi.org/10.1161/CIR.0000000000000427Circulation. 2016;134:e113This article corrects the followingInfective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of ComplicationsIn the article by Baddour et al, “Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association,” which published ahead of print on September 15, 2015, and appeared in the October 13, 2015, issue of the journal (Circulation. 2015;132:1435–1486. DOI: 10.1161/CIR.0000000000000296), several corrections were needed.On pages 1446–1463, the levels of headings have been updated.On page 1447, in the bottom of the left column, the third recommendation read, “Vancomycin alone may be a reasonable alternative in patients who are intolerant of β-lactam therapy (Class IIb; Level of Evidence C).” The strength of the recommendation has been updated to read, “(Class IIa; Level of Evidence C).”On page 1448, in Table 8, the third row, fourth column, the Level of Evidence has been updated from “B” to “C.”On page 1457, in the right column, the second heading, “Double–β-Lactam Regimens,” has been updated to “Double–β-Lactam Regimens for E faecalis IE.”On page 1462, in Table 16, the following changes have been made:First row, third column (“Duration, wk”), the entry read, “4.” It has been updated to read, “4, NVE; 6, PVE.”Second line of the table legend, a definition has been added: “NVE, native valve infective endocarditis.”On page 1464, in the left column, fourth paragraph, second sentence, reference 217 has been updated to reference 230.On page 1469, the following changes have been made:Left column, first paragraph, second sentence, reference 12 has been updated to reference 17.Left column, first paragraph under the heading “Anticoagulation,” third sentence, reference 287 has been updated to reference 286.Left column, last paragraph, second sentence, reference 288 has been updated to reference 287, and reference 289 has been updated to reference 288.Right column, first paragraph, last sentence, reference 290 has been updated to reference 289.Right column, second paragraph, first sentence, reference 291 has been updated to reference 290.These corrections have been made to the current online version of the article, which is available at http://circ.ahajournals.org/content/132/15/1435.full.FootnotesCirculation is available at http://circ.ahajournals.org. Previous Back to top Next FiguresReferencesRelatedDetailsCited By (2020) Arthritis as a manifestation of infective endocarditis, The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", 10.26565/2313-6693-2020-39-13:39, . Halford B, Piazza M, Berka H and Taylor C (2019) Blocking a rash diagnosis: a rare case of infective endocarditis, BMJ Case Reports, 10.1136/bcr-2018-226213, 12:3, (e226213), Online publication date: 1-Mar-2019. Popov D (2018) Daptomycin in the treatment of infective endocarditis, Clinical Microbiology and Antimicrobial Chemotherapy, 10.36488/cmac.2018.1.35-40, 20:1, (35-40), . Gallagher R, Wilson M, Hite P and Jackson B (2020) A Case Report of Acute Heart Failure Due to Infective Aortic Endocarditis Diagnosed by Point-of-care Ultrasound, Clinical Practice and Cases in Emergency Medicine, 10.5811/cpcem.2020.3.45002, 4:2, (193-196) Ajaka L, Heil E and Schmalzle S (2020) Dalbavancin in the Treatment of Bacteremia and Endocarditis in People with Barriers to Standard Care, Antibiotics, 10.3390/antibiotics9100700, 9:10, (700) Related articlesInfective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of ComplicationsLarry M. Baddour, et al. Circulation. 2015;132:1435-1486 August 23, 2016Vol 134, Issue 8 Advertisement Article InformationMetrics © 2016 American Heart Association, Inc.https://doi.org/10.1161/CIR.0000000000000427PMID: 27550972 Originally publishedAugust 23, 2016 PDF download Advertisement

A very rare case of infective endocarditis

A very rare case of infective endocarditis

Aortic root abscess presenting as alternating bundle branch block: Infective endocarditis of bicuspid aortic valve

Bicuspid aortic valve is the most common congenital cardiac malformation, affecting 1%–2% of the population. Among various complications, incidence of infective endocarditis (IE) in the bicuspid aortic valve population is high with higher rate of periannular extension resulting in conduction disturbances. Here we are reporting a rare case of infective endocarditis of bicuspid aortic valve presented with alternating bundle branch block.

A rare case of infective endocarditis caused by Candida albicans

Despite significant advances in medical, surgical, and critical care interventions, infective endocarditis (IE) remains a disease associated with considerable morbidity and mortality. Fungal endocarditis is relatively unusual in children although it is one of the most feared forms of endocarditis. Candida species are the most common organisms recovered. In neonates, this infection may be a complication of intensive care measures, including hyperalimentation fluid infusion, use of broad-spectrum antibiotics for a prolonged time, and extended use of indwelling venous catheters. The mortality rate from fungal endocarditis is high, even with intensive medical and surgical therapy. The present paper aimed to present a third-month-old girl baby with candida infective endocarditis (fungus ball) diagnosed and surgically operated.

Abiotrophia defectiva endocarditis presenting with hemiplegia

Abiotrophia defectiva was previously known as a member of the nutritionally variant streptococcus (NVS). This microorganism is a member of the normal flora of mouth, urogenital and intestinal tracts. It causes various infections such as bacteriemia, brain abscess, septic arthritis and rarely infective endocarditis. Only < 1% of all cases of endocarditis are caused by A. defectiva. A 23 year old previously healthy female was admitted to emergency department for left hemiplegia. On physical examination, petechial rashes were detected on her palmar and plantar regions. Magnetic resonance image of brain revealed acute enfarctus in the striatocapsuler area, and total occlusion was detected in right median common arterial segment M1 with magnetic resonance imaging angiography. Urgent thrombectomy was performed. Echocardiography demonstrated a mobile vegetation on mitral valve leaflet. Infective endocarditis was diagnosed and ceftriaxone at 2gr/day and vancomycin at 2 gr/day doses were started. A. defectiva was isolated in blood cultures. Antibiotics were changed to ampicillin/sulbactam at 8 gr/day and vancomycin at 2 gr /day doses. Infective endocarditis caused by A. defectiva and other nutritionally variant streptococci are reported to have a higher mortality, morbidity and complication rates. In the current communication we report this rather rare case of infective endocarditis.

Usefulness of 16S rDNA sequencing for the diagnosis of infective endocarditis caused by Corynebacterium diphtheriae

We report a rare case of infective endocarditis caused by Corynebacterium diphtheriae in an 8-year-old boy, 2 years after a right ventricular outflow tract reconstruction with a bovine Contegra valved conduit. The patient recovered well after an RV-PA conduit enblock explantation and replacement with an aortic homograft with antibiotic treatment. All bacteriological cultures of excised tissue and blood were negative. The aetiological agent was identified as C. diphtheriae subsp. gravis by 16s rDNA sequencing.