Vegetative Valvular Endocarditis Research Articles

Enterococcus casseliflavus infection in a captive Southern Cassowary (Casuarius casuarius): clinical and post-mortem findings.

An adult 22-year-old, male southern cassowary (Casuarius casuarius) presented for lethargy, dysorexia and soft feces. Clinical findings under chemical immobilization were unremarkable except for heterophilic toxic changes on blood smear, reduced albumin/globulin ratio and potentially elevated liver parameters. The animal was treated for suspected hepatobiliary insufficiency and received supportive treatment with daily subcutaneous fluids and medication and was monitored with a quality-of-life assessment. It was eventually euthanized after further deterioration. Post-mortem examination revealed vegetative valvular endocarditis, bile duct obstruction, cholangiohepatitis and splenitis with intralesional Enterococcus casseliflavus isolated. This is a first documented case of E. casseliflavus infection in a bird with multiorgan involvement.

Pathology of vegetative valvular endocarditis associated with ß-haemolytic Streptococci in pigs

Pathology of vegetative valvular endocarditis associated with ß-haemolytic Streptococci in pigs

Vegetative valvular endocarditis due to Enterococcus faecalis in a broiler chicken

Vegetative valvular endocarditis due to Enterococcus faecalis in a broiler chicken

Ulcerative Dermatitis and Valvular Endocarditis Associated withStaphylococcus aureusin a Hyacinth Macaw (Anadorhynchus hyacinthinus)

An 18-yr-old male hyacinth macaw (Anadorhynchus hyacinthinus) was found dead in his aviary with no preexisting signs. The bird had a chronic history of feather damaging behavior, with severe ulcerative dermatitis. Pathologic findings revealed a vegetative valvular endocarditis, myocarditis, septicemia, chronic severe glomerulonephritis, and thyroid dysplasia. Staphylococcus aureus was isolated from the valve, the liver, and the skin. Repeated trauma and low-rate bacteriemia may have contributed to the development of endocarditis. Translocation of S. aureus skin infection in the bloodstream may lead to subacute endocarditis in humans and such mechanism is suspected in this case. This case suggests that endocarditis associated with S. aureus septicemia is a potential complication of feather damaging behavior. This case also reports a systemic complication of ulcerative dermatitis secondary to feather damaging behavior. Endocarditis has been poorly reported in psittacine species, and such medical complication of feather damaging behavior has never been reported to our knowledge. Furthermore, S. aureus is a bacteria of public health concern and should be integrated into the differential when pet parrots with dermatitis are in proximity to owners.

Novel Bartonella infection in northern and southern sea otters (Enhydra lutris kenyoni and Enhydra lutris nereis)

Since 2002, vegetative valvular endocarditis (VVE), septicemia and meningoencephalitis have contributed to an Unusual Mortality Event (UME) of northern sea otters in southcentral Alaska. Streptococcal organisms were commonly isolated from vegetative lesions and organs from these sea otters. Bartonella infection has also been associated with bacteremia and VVE in terrestrial mammals, but little is known regarding its pathogenic significance in marine mammals. Our study evaluated whether Streptococcus bovis/equinus (SB/E) and Bartonella infections were associated with UME-related disease characterized by VVE and septicemia in Alaskan sea otter carcasses recovered 2004–2008. These bacteria were also evaluated in southern sea otters in California. Streptococcus bovis/equinus were cultured from 45% (23/51) of northern sea otter heart valves, and biochemical testing and sequencing identified these isolates as Streptococcus infantarius subsp. coli. One-third of sea otter hearts were co-infected with Bartonella spp. Our analysis demonstrated that SB/E was strongly associated with UME-related disease in northern sea otters (P<0.001). While Bartonella infection was also detected in 45% (23/51) and 10% (3/30) of heart valves of northern and southern sea otters examined, respectively, it was not associated with disease. Phylogenetic analysis of the Bartonella ITS region allowed detection of two Bartonella species, one novel species closely related to Bartonella spp. JM-1, B. washoensis and Candidatus B. volans and another molecularly identical to B. henselae. Our findings help to elucidate the role of pathogens in northern sea otter mortalities during this UME and suggested that Bartonella spp. is common in sea otters from Alaska and California.

Successful treatment ofBartonella henselaeendocarditis in a cat

This report describes the clinical presentation, diagnosis and treatment of a cat with vegetative valvular endocarditis temporally associated with natural infection with Bartonella henselae. Lethargy, abnormal gait and weakness were the main clinical signs that resulted in referral for diagnostic evaluation. Using a novel and sensitive culture approach, B henselae was isolated from the blood. Following antibiotic therapy there was total resolution of clinical signs, the heart murmur, the valvular lesion by echocardiography, and no Bartonella species was isolated or amplified from a post-treatment blood culture. In conjunction with previous case reports, infective endocarditis can be associated with natural B henselae infection in cats; however, early diagnosis and treatment may result in a better prognosis than previously reported.

Endocarditis in Chickens Caused by Subclinical Infection of Streptococcus gallolyticus subsp. gallolyticus

Streptococcus gallolyticus subsp. gallolyticus causes endocarditis in humans and acute septicemia in domestic birds. We describe here the infective endocarditis caused by the bacterium found among clinically healthy broilers at two abattoirs in Japan. The chickens were thought to be healthy because of the lack of clinical symptoms and normal levels of mortality before slaughtering. At the time of inspection, some chickens were condemned because of organ disorders characterized by vegetative valvular endocarditis as well as focal necrosis in heart, liver, and spleen. Streptococcus gallolyticus subsp. gallolyticus was isolated from the organs as a pure culture, indicating that the bacterium probably was the causative agent of the disorders. Amplified fragment length polymorphism analysis of the isolates collected at the abattoirs from chickens grown in nine different farms indicated that the isolates were different variants of the same clonal lineage and may have been derived from the same ancestor. These results suggest that S. gallolyticus subsp. gallolyticus causes infectious endocarditis in chickens and that healthy chickens may possess the bacterium in their normal flora as an opportunistic pathogen.

Reproduction of sepsis and endocarditis by experimental infection of chickens with Streptococcus gallinaceus and Enterococcus hirae

This study describes experimental infections in 4-week-old chickens inoculated intravenously with approximately 108 colony-forming units Streptococcus gallinaceus strain CCUG 42692T (C13156) or Enterococcus hirae strain DSM 20160 (C17410). Birds were necropsied following death and obvious clinical signs of disease or were euthanized weekly after infection for up to 4 weeks. At necropsy, lesions included splenomegaly, hepatomegaly, valvular and/or mural endocarditis. Cardiac lesions included focal necrotizing myocarditis and/or yellow–white vegetative valvular endocarditis or greyish proliferations associated with the mitral valves in 35% (6/20) and 79% (19/24) of birds infected with S. gallinaceus and in 20% (4/20) and 55% (12/22) of birds infected with E. hirae via the brachial and jugular veins, respectively. S. gallinaceus was reisolated from heart valves in 45% (9/20) and 75% (18/24) and E. hirae in 35% (7/20) and 73% (16/22) after inoculation via brachial and jugular veins, respectively. Both challenge strains were also isolated from liver, spleen, bone marrow and hock joints. A significant difference between the infections with the two strains was seen only with reisolation of E. hirae from hock joints (P<0.007). Significant differences were apparent between the two inoculation routes only with E. hirae, where infection via the jugular vein was associated with higher culture positive isolations from the heart (P=0.029), bone marrow (P=0.002) and hock joints (P<0.001) compared with the brachial vein. Birds injected with sterile phosphate-buffered saline were negative for culture of the challenge strains and no lesions were observed in these controls. The results confirm that both S. gallinaceus and E. hirae can cause endocarditis in experimentally infected chickens.

Cyclic CD8+ lymphopenia in dogs experimentally infected with Bartonella vinsonii subsp. berkhoffii

Until recently, it was presumed that Bartonella vinsonii only infected voles, a species of North American rodents. In April of 1993, however, our laboratory isolated a novel subspecies of B. vinsonii ( B. vinsonii subsp. berkhoffii) from the blood of a dog diagnosed with vegetative valvular endocarditis. Subsequently, based on a seroepidemiologic survey of dogs from North Carolina and Virginia presenting for a variety of medical problems, we found evidence supporting a potentially important association between B. vinsonii and Ehrlichia canis co-infection in dogs. In the following study, eight dogs were infected with B. vinsonii: four specific pathogen free dogs and four dogs that had previously been infected with E. canis. Flow cytometric analysis of peripheral blood lymphocytes revealed a cyclic elevation of the CD4/CD8 T-cell ratio that correlated with cyclic CD8+ lymphopenia in all dogs infected with B. vinsonii, regardless of prior exposure to E. canis.