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Native valve endocarditis due to Micrococcus luteus: a case report and review of the literature.

Miltiadous G, Elisaf M - J Med Case Rep (2011)

Bottom Line: Our patient was unsuccessfully treated with vancomycin, gentamicin and rifampicin for four weeks.Prosthetic infective endocarditis due to M luteus is rare.To the best of our knowledge, we report the first case in the literature involving a native valve.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hippocrateon Private Hospital, Nicosia, Cyprus. me00521@cc.uoi.gr.

ABSTRACT

Introduction: Micrococcus luteus endocarditis is a rare case of infective endocarditis. A total of 17 cases of infective endocarditis due to M luteus have been reported in the literature to date, all involving prosthetic valves. To the best of our knowledge, we describe the first case of native aortic valve M luteus endocarditis in an immunosuppressed patient in this report.

Case report: A 74-year-old Greek-Cypriot woman was admitted to our Internal Medicine Clinic due to fever and malaise and the diagnosis of aortic valve M luteus endocarditis was made. She was immunosuppressed due to methotrexate and steroid treatment. Our patient was unsuccessfully treated with vancomycin, gentamicin and rifampicin for four weeks. The aortic valve was replaced and she was discharged in good condition.

Conclusions: Prosthetic infective endocarditis due to M luteus is rare. To the best of our knowledge, we report the first case in the literature involving a native valve.

No MeSH data available.


Related in: MedlinePlus

Transthoracic echocardiography, showing a vegetation of about 1 cm on the aortic valve.
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Figure 1: Transthoracic echocardiography, showing a vegetation of about 1 cm on the aortic valve.

Mentions: On admission we conducted chest X-ray and upper abdomen ultasonography, the results of which were normal. An electrocardiogram (ECG) showed a right bundle branch block. Three subsequent blood cultures were drawn over a period of one hour and two of them grew M luteus. Transthoracic echocardiography was performed, showing a vegetation of about 1 cm on the aortic valve (Figure 1). A diagnosis of infective endocarditis was established according to the Duke criteria [6]. In fact, one major (valvular vegetation) and three minor (fever > 38°C, elevated RF and positive blood cultures of a microorganism that do not typically cause infective endocarditis) criteria were met (of note, two months earlier our patient's yearly check-up had showed normal plasma RF levels). In addition, during the course of the disease our patient had a brain embolic event. Therefore, an additional minor criterion was also met.


Native valve endocarditis due to Micrococcus luteus: a case report and review of the literature.

Miltiadous G, Elisaf M - J Med Case Rep (2011)

Transthoracic echocardiography, showing a vegetation of about 1 cm on the aortic valve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3141704&req=5

Figure 1: Transthoracic echocardiography, showing a vegetation of about 1 cm on the aortic valve.
Mentions: On admission we conducted chest X-ray and upper abdomen ultasonography, the results of which were normal. An electrocardiogram (ECG) showed a right bundle branch block. Three subsequent blood cultures were drawn over a period of one hour and two of them grew M luteus. Transthoracic echocardiography was performed, showing a vegetation of about 1 cm on the aortic valve (Figure 1). A diagnosis of infective endocarditis was established according to the Duke criteria [6]. In fact, one major (valvular vegetation) and three minor (fever > 38°C, elevated RF and positive blood cultures of a microorganism that do not typically cause infective endocarditis) criteria were met (of note, two months earlier our patient's yearly check-up had showed normal plasma RF levels). In addition, during the course of the disease our patient had a brain embolic event. Therefore, an additional minor criterion was also met.

Bottom Line: Our patient was unsuccessfully treated with vancomycin, gentamicin and rifampicin for four weeks.Prosthetic infective endocarditis due to M luteus is rare.To the best of our knowledge, we report the first case in the literature involving a native valve.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hippocrateon Private Hospital, Nicosia, Cyprus. me00521@cc.uoi.gr.

ABSTRACT

Introduction: Micrococcus luteus endocarditis is a rare case of infective endocarditis. A total of 17 cases of infective endocarditis due to M luteus have been reported in the literature to date, all involving prosthetic valves. To the best of our knowledge, we describe the first case of native aortic valve M luteus endocarditis in an immunosuppressed patient in this report.

Case report: A 74-year-old Greek-Cypriot woman was admitted to our Internal Medicine Clinic due to fever and malaise and the diagnosis of aortic valve M luteus endocarditis was made. She was immunosuppressed due to methotrexate and steroid treatment. Our patient was unsuccessfully treated with vancomycin, gentamicin and rifampicin for four weeks. The aortic valve was replaced and she was discharged in good condition.

Conclusions: Prosthetic infective endocarditis due to M luteus is rare. To the best of our knowledge, we report the first case in the literature involving a native valve.

No MeSH data available.


Related in: MedlinePlus