scholarly journals Embolic Stroke and Meningitis Secondary to Staphylococcus lugdunensis Native Valve Endocarditis

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Wafa Ali AlDhaleei ◽  
Akshaya Srikanth Bhagavathula ◽  
Rabia Aldoghaither
Keyword(s):  
Infective Endocarditis ◽  
Mortality Rate ◽  
Surgical Intervention ◽  
Clinical Course ◽  
Embolic Stroke ◽  
Penicillin G ◽  
Coagulase Negative Staphylococcus ◽  
Staphylococcus Lugdunensis ◽  
Native Valve ◽  
Native Valve Endocarditis

Staphylococcus lugdunensis is a coagulase-negative staphylococcus that leads to destructive infective endocarditis. The clinical course of S. lugdunensis endocarditis is usually aggressive with a high mortality rate compared to endocarditis caused by other coagulase-negative staphylococcal species. Despite that, it is usually sensitive to Penicillin G, and surgical intervention is sometimes warranted. Here, we report a case of S. lugdunensis endocarditis complicated by both embolic stroke and meningitis.

scholarly journals Embolic Stroke Caused by Staphylococcus lugdunensis Endocarditis Complicating Vasectomy in a 36-Year-Old Man

2015 ◽  
Vol 42 (6) ◽  
pp. 585-587 ◽  
Author(s):  
Manova David ◽  
Megan Loftsgaarden ◽  
Felix Chukwudelunzu
Keyword(s):  
At Risk ◽  
Medical Literature ◽  
Clinical Course ◽  
The Body ◽  
Embolic Stroke ◽  
Inguinal Region ◽  
Staphylococcus Lugdunensis ◽  
Native Valve ◽  
Native Flora ◽  
Native Valve Endocarditis

Staphylococcus lugdunensis is part of the native flora in the inguinal region of the body. Inguinal surgeries, such as vasectomy, place carriers of this aggressive pathogen at risk for contamination. Native-valve endocarditis caused by coagulase-negative S. lugdunensis has a rapid and complicated clinical course. The pathogenicity of this organism is not limited to cardiac valvular destruction. We report the case of a 36-year-old man who presented with S. lugdunensis endocarditis, dysarthria, and hemiparesis 5 weeks after a vasectomy. To our knowledge, this is the first report of embolic stroke caused by S. lugdunensis endocarditis. In addition, we discuss the relevant medical literature.

Coagulase-negative staphylococcus endocarditis: staphylococcus lugdunensis

2011 ◽  
Vol 19 (6) ◽  
pp. 414-415 ◽  
Author(s):  
Amul K Sibal ◽  
Zaw Lin ◽  
Dilesh Jogia
Keyword(s):  
Surgical Treatment ◽  
Early Diagnosis ◽  
Fistula Formation ◽  
Coagulase Negative Staphylococcus ◽  
Staphylococcus Lugdunensis ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Triple Valve

Staphylococcus lugdunensis is an infrequent cause of native valve endocarditis. A case of triple-valve involvement of Staphylococcus lugdunensis with intracardiac fistula formation in a 47-year-old woman was managed successfully with surgery. The importance of early diagnosis and prompt referral for surgical treatment is highlighted.

Native valve endocarditis caused by Erysipelothrix rhusiopathiae in an immunocompetent individual

2013 ◽  
Vol 62 (12) ◽  
pp. 1911-1913 ◽  
Author(s):  
Selçuk Kaya ◽  
Eda Gençalioğlu ◽  
Seval Sönmez Yıldırım ◽  
Gökalp Altun ◽  
Gürdal Yılmaz ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mortality Rates ◽  
Penicillin G ◽  
Erysipelothrix Rhusiopathiae ◽  
Clinical Form ◽  
Native Valve ◽  
Immunocompetent Individual ◽  
Native Valve Endocarditis

Infective endocarditis is a very rare clinical form caused by Erysipelothrix rhusiopathiae. It is rarely seen in immunocompetent individuals. Even after surgery it may entail mortality rates as high as 30–40 %. This report describes a case of native valve endocarditis caused by E. rhusiopathiae and cured with crystallized penicillin G and surgery.

The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020

2020 ◽  
Vol 21 (12) ◽  
pp. 1140-1153 ◽  
Author(s):  
Mohammad A. Noshak ◽  
Mohammad A. Rezaee ◽  
Alka Hasani ◽  
Mehdi Mirzaii
Keyword(s):  
Foreign Body ◽  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Human Life ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Site Infections ◽  
Coagulase Negative Staphylococci ◽  
Native Valve ◽  
Native Valve Endocarditis

Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.

scholarly journals Corynebacterium jeikeium native valve infective endocarditis case report: a confirmed microbiological and pathological diagnosis from heart valvular tissue

2020 ◽  
Author(s):  
Wentzel Bruce Dowling ◽  
Johan Koen
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Penicillin G ◽  
Peripheral Vascular ◽  
Native Valve ◽  
Valve Tissue ◽  
Case Summary ◽  
Duke Criteria ◽  
G Prior ◽  
Initial Blood

Abstract Background The Modified Duke criteria is an important structured schematic for the diagnosis of infective endocarditis (IE). Corynebacterium jeikeium is a rare cause of IE that is often resistant to standard IE anti-microbials. We present a case of C. jeikeium IE, fulfilling the Modified Duke pathological criteria. Case summary A 50-year-old male presented with left leg peripheral vascular disease with septic changes requiring amputation. Routine echocardiography post-amputation demonstrated severe aortic valve regurgitation with vegetations that required valve replacement. Two initial blood cultures from a single venepuncture showed Streptococcus mitis which was treated with penicillin G prior to surgery. Subsequent aortic valve tissue cultured C. jeikeium with suggestive IE histological valvular changes and was successfully treated on a prolonged course of vancomycin. Discussion This is the first C. jeikeium IE case diagnosed on heart valvular tissue culture and highlights the importance for the fulfilment of the Modified Duke criteria in diagnosing left-sided IE. Mixed infection IE is rare, and this case possibly represents an unmasking of resistant C. jeikeium IE following initial treatment of penicillin G.

scholarly journals A case of vertebral osteomyelitis and native valve endocarditis caused by Staphylococcus lugdunensis

2017 ◽  
Vol 24 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Shintaro Minegishi ◽  
Yasuyuki Mochida ◽  
Shuta Furihata ◽  
Shinya Ichikawa ◽  
Masahiro Fukuoka ◽  
...  
Keyword(s):  
Vertebral Osteomyelitis ◽  
Staphylococcus Lugdunensis ◽  
Native Valve ◽  
Native Valve Endocarditis

Prosthetic valve endocarditis

ESC CardioMed ◽  
2018 ◽  
pp. 1720-1723
Author(s):  
José A. San Román ◽  
Javier López
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Antibiotic Treatment ◽  
Prosthetic Valve ◽  
Photon Emission ◽  
Clinical Manifestations ◽  
Prosthetic Valve Endocarditis ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Duke Criteria

Prosthetic valve endocarditis (PVE) complicates the clinical course of 1–6% of patients with prosthetic valves and it is one of the types of infective endocarditis with the worst prognosis. In early-onset PVE (that occurs within the first year after surgery), the microbiological profile is dominated by staphylococci. In late-onset PVE, the microorganisms are similar to native valve endocarditis. Clinical manifestations are very variable and depend on the causative microorganism. The diagnosis is established with the modified Duke criteria although they yield lower diagnostic accuracy than in native valve endocarditis. Transoesophageal echocardiography is the main imaging technique in everyday clinical practice in PVE as the sensitivity is higher than transthoracic echocardiography. The findings of other techniques, as cardiac computed tomography (CT), positron emission tomography/CT, or single-photon emission computed tomography/CT have been recently recognized as new major diagnostic criteria and can be very useful in cases with a high level of clinical suspicion and negative echocardiography. Empirical antibiotic treatment should cover the most frequent microorganisms, especially staphylococci. Once the microbiological diagnosis is made, the antibiotic treatment is similar to native valve infective endocarditis, except for the addition of rifampicin in staphylococcal PVE and a longer length (up to 6 weeks) of the treatment. Surgical indications are also similar to native valve endocarditis, heart failure being the most common and embolic prevention the most debatable. Prognosis is bad, and during the follow-up, a team experienced with endocarditis is needed. Patients with a history of PVE should receive antibiotic prophylaxis if they undergo invasive dental manipulations.

scholarly journals Vaccination with FimA from Streptococcus parasanguis Protects Rats from Endocarditis Caused by Other Viridans Streptococci

2002 ◽  
Vol 70 (1) ◽  
pp. 422-425 ◽  
Author(s):  
Todd Kitten ◽  
Cindy L. Munro ◽  
Aijuan Wang ◽  
Francis L. Macrina
Keyword(s):  
Infective Endocarditis ◽  
Virulence Factor ◽  
Rat Model ◽  
Oral Streptococci ◽  
Bacterial Challenge ◽  
Viridans Streptococci ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Streptococcal Species

ABSTRACT The FimA protein of Streptococcus parasanguis is a virulence factor in the rat model of endocarditis, and immunization with FimA protects rats against homologous bacterial challenge. Because FimA-like proteins are widespread among the oral streptococci, the leading cause of native valve endocarditis, we evaluated the ability of this vaccinogen to protect rats when challenged by other streptococcal species. Here we report that FimA vaccination produced antibodies that cross-reacted with and protected against challenge by the oral streptococci S. mitis, S. mutans, and S. salivarius. FimA thus has promise as a vaccinogen to control infective endocarditis caused by oral streptococci.

scholarly journals 472 Epidemiology and temporal trends of cardiac device related infective endocarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Denes ◽  
A Bence ◽  
T Ferenci ◽  
S Borbas ◽  
Z Som ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Temporal Trends ◽  
Mortality Rates ◽  
Coagulase Negative Staphylococcus ◽  
Cardiac Device ◽  
Native Valve ◽  
Tertiary Referral Center ◽  
Device Implantation ◽  
Epidemiological Characteristics ◽  
Over Time

Abstract Background Infective endocarditis (IE) is a rare, but life-threatening complication of cardiac device implantation. Despite recent preventive strategies, and advances in antimicrobial and surgical treatment, morbidity and mortality rates are still high. Aims The objective of our study was to assess the epidemiological characteristics, temporal tends and mortality rate of cardiac device related IE (CDRIE) in our high-volume, tertiary referral center. Methods retrospective data collection was performed from January 1, 2006 to December 31, 2016. Thirty-day, 6-month and 1-year mortality was estimated, which were compared to left-sided native valve endocarditis (LSNIE). Patients administered between 2006 and 2010 and between 2011 and 2016 were compared to assess temporal trends. Results 465 cases of IE were administered, out of whom 54 patients had CDRIE (39 males [72%], mean age: 55.8 ±19 yrs; 4 VVI, 7 VDD, 7 VVI-ICD, 20 DDD, 5 DDD-ICD and 11 CRT devices; median time since first implantation: 1558 days [IQR: 470 days – 8.6 yrs]). The infection was caused by streptococci in 3 cases (5.5%), Staphylococci were the most prevalent infective agents (70%), S. aureus (SA) in 28 cases (52%, out of whom 10 were MRSA), coagulase negative Staphylococcus in 10 cases (18.5%), blood culture negative cases in 8 patients (15%), and in 5 cases other pathogens were responsible. 266 patients had LSNIE (201 males [75%], mean age: 54.4 ± 15.6 yrs). There was no difference between the two groups in age or in portion of males. Mortality rates were the same in CDRIE group compared to LSNIE group (30-day: 13% vs 13%, 6-month: 20% vs 25%, 1-year: 26% vs 29% and long-term: 44% vs 44%, ns resp.) Patients who died in the CDRIE group (n = 25) were older (64 yrs [IQR:59-71 yrs] vs 52 yrs [IQR: 27-69 yrs], p = 0.02), male sex was less common (52% vs 79%, p = 0.03), had lower ejection fraction (39.6 ±16.6% vs 54.6 ±14.5%, p < 0.001), had worse renal function (GFR: 46.3 ± 15.3 vs 60.2 ± 23.5 ml/min/1.73m2, p = 0.04), shorter time since first device implantation (2.1 yrs [IQR: 1.1-4.8 yrs] vs 6.7 yrs [4.1-12.9 yrs], p = 0.006), and CRT device implantation were more prevalent (32% vs 10%, p < 0.05). Patients admitted before 2011 (n = 22) did not differ from patients admitted after 2011 (n = 32) in terms of age, male gender, concomitant valve infection, pocket infection, or embolic event. The 30-day (0% vs 6%) and the 1-year mortality (18% vs 31%) were the same before and after 2011, but the 6-month mortality was better before 2011 (4.5% vs 31%, p = 0.01). CRT device implantation was more prevalent over time (5% vs 31%, p = 0.01), and SA infection became more frequent (36% vs 63%, p = 0.05) Conclusions During the last decade patients with CDRIE had a same survival as patients with LSNIE, every fourth patient died one year after the diagnosis. Almost three-quarter of the infections were caused by Staphylococci, and the portion of S. aureus infection increased over time.

scholarly journals 402. Clinical Characteristics and Outcome of Staphylococcus lugdunensis Prosthetic Joint Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S205-S205
Author(s):  
Komal Masood ◽  
Joan Duggan ◽  
Roberta Redfern ◽  
Gregory Georgiadis ◽  
Geehan Suleyman
Keyword(s):  
Clinical Characteristics ◽  
Surgical Intervention ◽  
Treatment Modalities ◽  
Coagulase Negative Staphylococcus ◽  
Two Stage ◽  
Staphylococcus Lugdunensis ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Significant Difference

Abstract Background Although Staphylococcus lugdunensis is a coagulase-negative staphylococcus, it shares similar characteristics with S. aureus and is increasingly recognized as the cause of serious infections, including prosthetic joint infections (PJIs). The aim of this study was to determine the clinical characteristics and outcome of S. lugdunensis PJIs. Methods This was a retrospective multicenter study conducted from January 2007 through December 2017 involving consecutive adult patients with S. lugdunensis PJIs in northwest Ohio. Clinical and microbiologic characteristics, treatment modalities and outcome were evaluated. Results A total of 695 patients were evaluated and 29 (4%) patients met inclusion criteria (Table 1). All patients were Caucasian and 52% were female with a median age 68.8. Comorbidities included Diabetes Mellitus (34%), CAD (41%), CHF (20%), COPD (20%) and cancer (14%). The most common clinical presentations were pain (28/29, 97%), decreased range of motion (27/29, 93%) and joint swelling (21/29, 72%). Two patients had concomitant bacteremia. Knee was the most commonly affected joint (69%), followed by hip (24%). All isolates, except one, were susceptible to oxacillin. Thirteen (45%) patients had a two-stage revision, nine (31%) debridement with/without revision, six (21%) no surgical intervention and one (3%) a 1-stage revision. The majority of patients (71%) received ≥4 weeks of antibiotics (abx). Two patients with no surgical intervention and one with debridement received no abx. Another was discharged to hospice without intervention. Relapse was observed in two (15%) patients who had a 2-stage revision, four (44%) who had debridement, 6 (100%) who had no surgical intervention or 1-stage revision. Overall, there was a statistically significant difference in cure rates in patients who underwent 2-stage revision compared with other treatment modalities (P = 0.003) regardless of abx treatment regimen, including prolonged IV abx therapy. However, IV abx were superior to oral (P = 0.009). Conclusion Appropriate management of S. lugdunensis PJIs includes both aggressive surgical management with a prolonged course of abx with excellent clinical responses. Relapse is high in patients treated without two-stage revision irrespective of route or duration of abx therapy. Disclosures All authors: No reported disclosures.

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