First case report of prosthetic valve endocarditis caused by Mycobacterium wolinskyi |
| |
| Authors: | Heita Kitajima Yuichiro Oba Takahisa Ohira Tomohiro Asaoka Yoshihiro Atsumi Takahiro Nakajima Takayuki Okura |
| |
| Affiliation: | 1. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan;2. Department of Hematology, Kansai Electrical Power Hospital, Osaka, Japan;3. Department of Hematology, Kyoto-Katsura Hospital, Kyoto, Japan;4. Senri Kinran University, Osaka, Japan;1. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Aichi, 467-8601, Japan;2. Division of Infection Prevention & Control, Nagoya City University Hospital, Aichi, 467-8601, Japan;1. Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan;2. Office for Infection Control, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan;3. Organ Transplantation Center, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan;4. Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA;1. Department of Microbiology, Tokyo Medical University, Tokyo, Japan;2. Department of Infectious Diseases, St Luke''s International Hospital, Tokyo, Japan;3. Metaboscreen Company, Ltd., Kanagawa, Japan;4. Department of Microbiology, St. Marianna University School of Medicine, Kanagawa, Japan;5. Graduate School of Public Health, St. Luke''s International University, Tokyo, Japan;6. Department of Infectious Diseases, International University of Health and Welfare, Chiba, Japan |
| |
| Abstract: | To date, only 26 cases of Mycobacterium wolinskyi infections have been reported in humans. We herein report a first case of prosthetic valve endocarditis due to this organism after cardiovascular surgery. An 82-year-old man presented with repeat episodes of syncope and fever after aortic valve replacement, mitral valve replacement, left atrial appendage closure, and pulmonary vein isolation. Blood cultures maintained in aerobic bottles were repeatedly positive after 90–100 hours, and Gallium scan revealed abnormal accumulations in the sternum and left testis. While colonies formed by culturing the fluid of the parasternal area and blood cultures revealed gram-positive rods, we could not analyze the colony using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF). M. wolinskyi was finally identified on 16S rRNA, hsp65, and rpoB gene sequencing. We treated the patient with multiple antimycobacterial drugs, i.e., amikacin, imipenem, and clarithromycin for 6 weeks, which was changed to oral ciprofloxacin and minocycline for 12 months. This case highlights the need to consider rapidly growing mycobacteria, including M. wolinskyi, if chronic fever persists from weeks to months after surgery, the blood culture is positive, and the organism is not identified. In addition, sequencing the 16S rRNA, hsp65, and rpoB genes is essential for diagnosis. |
| |
| Keywords: | Mycobacterium wolinskyi Prosthetic valve endocarditis 16S rRNA gene hsp 65 gene rpoB gene |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
