Prosthetic valve endocarditis caused by Acinetobacter lwoffi: a case report and review

We are reporting a case of recurrent prosthetic-valve endocarditis (PVE) caused by an unusual pathogen. The patient suffered 2 consecutive relapses of Acinetobacter lwoffi bacteremia, although he had completed a full course of treatment with antibiotics to which the microorganism was susceptible. He was finally successfully operated with replacement of the infected aortic valve. Acinetobacter spp are relatively low-grade but potentially virulent pathogens, and endocarditis caused by these species can be fulminant, accompanied by septic complications, and fatal. Although some patients with relapsed PVE may respond to a second course of antibiotics and medical treatment rather than early valve replacement is suggested in A lwoffi PVE, combined antibiotic treatment and early surgical intervention may be considered as the first option in these patients.There are only a few cases of Acinetobacter endocarditis in the literature, and it is the first case reported in Greece to our knowledge.     

Eustachian valve endocarditis: Detection with multiplane transesophageal echocardiography

Right-sided involvement is fairly common in infective endocarditis, but involvement of the eustachian valve is distinctly rare. We present the case of a 36-year-old intravenous drug user with staphylococcal bacteremia and septic pulmonary emboli. Transthoracic echocardiography was normal, but transesophageal echocardiography revealed a large eustachian valve vegetation. This case illustrates the utility of multiplane transesophageal echocardiography in the evaluation of eustachian valve pathology.     

Prosthetic valve endocarditis caused by Gemella sanguinis: a consequence of persistent dental infection

Late prosthetic valve endocarditis is usually caused by streptococci, staphylococci, gram-negative bacilli and candida. The authors report the first case of prosthetic valve endocarditis caused by Gemella sanguinis. The patient's risk factors for the development of Gemella endocarditis were the persistent severe dental caries and the presence of prosthetic valves. The patient required surgical replacement of the infected valve but had a good outcome with preservation of cardiac and valvular function. Evaluation and treatment of the persistent dental infection before initial valvular surgery may have prevented secondary infection of the prosthetic valve.     

Prosthetic aortic valve abscess producing total right coronary artery occlusion: diagnosis by transesophageal three-dimensional echocardiography

We present a patient with total right coronary artery occlusion produced by a prosthetic aortic valve abscess. The diagnosis was made by transesophageal three-dimensional echocardiography.     

Propionibacterium acnes endocarditis in a native valve complicated by intraventricular abscess: a case report and review.

Propionibacterium acnes is a constituent of the normal skin flora. It has been described as causing infection on prosthetic valves but very rarely on native valves. We describe a case of aggressive P. acnes endocarditis in a healthy 36-y-old man which infected a native aortic valve and was complicated by an aortic root abscess and review the literature.     

Legionella micdadei prosthetic valve endocarditis complicated by brain abscess: case report and review of the literature

Legionella endocarditis is extremely uncommon, and embolic phenomena have never been reported. We report the first case of Legionella micdadei prosthetic valve endocarditis complicated by brain abscess. A 57-y-old immunocompromised woman with a history of mitral valve replacement developed confusion and left-sided weakness. Brain magnetic resonance imaging showed a 3-cm peripheral-enhancing mass. Transoesophageal echocardiography suggested a perivalvular abscess. Blood cultures and valve cultures were negative. She was diagnosed with 16S rRNA polymerase chain reaction and silver stain, and was discharged with levofloxacin after a redo mitral valve replacement. Twelve cases of Legionella endocarditis were reviewed. Only one case had a native valve, and her endocarditis occurred after pneumonia. All cases were cured. The duration of antibiotic therapy was variable. Legionella species should be considered in the differential diagnosis of culture-negative endocarditis in both immunocompetent and immunocompromised patients. Molecular techniques and silver impregnation stains are useful, especially when cultures using buffered charcoal-yeast extract agar are negative.     

Reactive arthritis and subacute infective endocarditis caused by Streptococcus gordonii infection: A case report

Streptococcus gordonii (S. gordonii) belongs to the alpha-hemolytic Streptococcus group. It is a symbiotic bacterium found in the human oral mucosa which is present in large quantities on the surface of the teeth. It is generally considered nonpathogenic or weakly pathogenic and is known to cause subacute endocarditis; however, there are few reports of reactive arthritis (ReA) caused by S. gordonii. Herein, we report a case of ReA complicated by subacute infective endocarditis caused by S. gordonii and explore the possible pathogenic mechanism of ReA caused by S. gordonii.     

糖尿病肾病合并起搏器感染、胸骨后脓肿及感染性心内膜炎1例

糖尿病伴多器官并发症的诊治复杂,同时合并心血管疾病、肾脏病及起搏器感染等更为困难。本文报道1例患有糖尿病肾病、肾功能不全、陈旧性心肌梗死、糖尿病足、脓毒血症、起搏器感染、胸骨后脓肿、骨髓炎和感染性心内膜炎的病例,经肾脏替代治疗(RRT)、足部清创换药、拔除起搏器和足疗程抗生素后治疗病情好转。本病例的诊治提示我们糖尿病肾功能衰竭合并起搏器感染患者要及时拔除起搏器并应用足量敏感抗生素,早期RRT或可使患者获益。     

Thigh abscess caused by Eikenella corrodens and Streptococcus intermedius: a case report

A 35-year-old Chinese female has a large thigh abscess without a clear source. No underlying diseases were revealed in the patient. The combination of clindamycin and cefazolin or vancomycin was administered but without a clinical response. Eikenella corrodens and Streptococcus intermedius were isolated from puncture drainage. Then, ceftriaxone was administered and a surgery of incision and further draining was carried. Eventually, the patient recovered. To our knowledge, this is the first case of thigh abscess in a previous healthy adult.     

缓症链球菌肝脓肿1例报告

化脓性肝脓肿(pyogenic liver abscess,PLA)以大肠埃希菌和肺炎克雷伯杆菌感染为主[1],缓症链球菌(Streptococcus mitis,S.mitis)属于条件致病菌,致病力较弱,国内尚无由其引起PLA的报道。本文报道解放军总医院第八医学中心近期收治的1例S.mitis感染导致肝脓肿的病例,以提高临床医师对该病的认识。     

Infective endocarditis complicated by abscess and perforation of mitral valve--a case report

A case of a 47-year-old male admitted to our department due to acute myocardial infarction, treated effectively with primary angioplasty, is presented. Three weeks earlier the patient was admitted to another hospital with a suspicion of infective endocarditis. Echocardiography performed in our department after the patient recovered from acute phase of MI revealed the presence of mitral valve abscess which caused valve perforation. The patient was transferred to another institution for cardiac surgery.     

Isolated pulmonary valve endocarditis: a case report

The authors report the very rare case of isolated pulmonary valve endocarditis in the absence of classical predisposing factors and discuss the therapeutic approach. In the absence of large series, a maximum of information is developed from this new case, especially with respect to its unusual context.     

Pulmonary valve endocarditis caused by Streptococcus D bovis in a patient with a colorectal adenocarcinoma

A case of pulmonary endocarditis caused by Streptococcus D bovis in a female patient with colorectal adenocarcinoma is reported. The M-mode and two-dimensional echocardiographic and pulsed doppler ultrasound findings are described. A review of the literature shows that Streptococcus D bovis pulmonary endocarditis is rare. Any septicaemia or endocarditis caused by this organism calls for invasive exploration of the digestive tract, and especially the colon.     

Isolated pulmonic valve endocarditis caused by group B streprococcus (Streptococcus agalactiae)--a case report and literature review

The pulmonic valve is the least commonly involved valve in infective endocarditis. Pulmonic valve endocarditis is usually associated with tricuspid valve endocarditis, and isolated pulmonic valve endocarditis is exceedingly rare. The predisposing factors for developing pulmonic valve endocarditis include a congenitally anomalous pulmonic valve, intravenous drug abuse, and the presence of indwelling intravenous or flow-directed pulmonary artery catheters. More cases of group B streptococcus endocarditis are being reported. The risk factors for group B streptococcus endocarditis include diabetes mellitus, cancer, alcoholism, malnutrition, immunocompromised status, intravenous drug abuse, postpartum and postabortion states, and underlying valvular disease. The vegetations of this type of endocarditis are usually large and have a higher tendency to result in embolism. The presentation of group B streptococcus endocarditis is usually acute and may result in rapid valve destruction if not treated promptly. A case of isolated pulmonic valve endocarditis caused by group B streptococcus, Streptococcus agalactiae, is presented that was diagnosed with multiplane transesophageal echocardiography in a 40-year old, alcoholic, malnourished man, who was successfully treated with intravenous penicillin G. The literature on the isolated pulmonic valve endocarditis caused by group B streptococcus is reviewed.     

1型糖尿病合并胃溃疡毛霉菌感染1例

胃肠道毛霉菌病的发病率占所有毛霉菌病的5%~13%,临床诊断困难,病死率高。本文报道1例48岁女性患者,病程1个月,以腹痛、腹胀、发热为主要表现,有1型糖尿病史,血糖控制差。患者入院后病情加重,有消化道出血表现,行胃镜检查提示胃体多发巨大溃疡,溃疡表面有白苔覆着,胃黏膜病理活检提示可见少许真菌菌丝及孢子;PAS和六胺银...