Infective Endocarditis Due to Presenting with Musculoskeletal Symptoms

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2019 Aug 31

PMID 31466970

Citations 3

Authors

Saira Farid

Zerelda Esquer Garrigos

M Rizwan Sohail

Affiliations

Soon will be listed here.

Abstract

A 62-year-old man with essential hypertension and right L4-L5 hemilaminectomy was referred to rheumatology for evaluation of severe arthralgia and myalgia for 12 months. Review of symptoms was significant for night sweats and 20 pounds unintentional weight loss. Physical examination was significant for holosystolic murmur best heard at the cardiac apex of unclear chronicity. Laboratory investigations revealed elevated inflammatory markers, white blood cell count and B-type natriuretic peptide. Transoesophageal echocardiogram showed flail posterior mitral leaflet with severe mitral regurgitation and two vegetations (2.5×1 cm and 1.6×0.3 cm). Abdominal CT showed new focal splenic infarcts, and a brain MRI revealed subacute infarcts, consistent with the embolic phenomenon. Blood cultures grew The patient underwent mitral valve replacement surgery followed by 6 weeks of parenteral therapy with vancomycin and gentamicin, with full recovery at a 3-month follow-up.

Citing Articles

Posterior Mitral Leaflet Prolapse and Subsequent Mitral Valve Endocarditis Complicated With Anterior Leaflet Perforation.

Sasaki H, Numata Y, Saito J, Kamiya S, Asano M Cureus. 2023; 15(3):e36315.

PMID: 37077597 PMC: 10109018. DOI: 10.7759/cureus.36315.

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review.

Hakoshima M, Kitakaze K, Adachi H, Katsuyama H, Yanai H J Clin Med Res. 2023; 15(1):38-50.

PMID: 36755765 PMC: 9881492. DOI: 10.14740/jocmr4836.

Challenges in the diagnosis and management of endocarditis in a 9-year-old child.

Holloway V, Jacob G, Hayes N BMJ Case Rep. 2021; 14(2).

PMID: 33602775 PMC: 7896593. DOI: 10.1136/bcr-2020-240079.

References

Casalta J, Habib G, La Scola B, Drancourt M, Caus T, Raoult D . Molecular diagnosis of Granulicatella elegans on the cardiac valve of a patient with culture-negative endocarditis. J Clin Microbiol. 2002; 40(5):1845-7. PMC: 130947. DOI: 10.1128/JCM.40.5.1845-1847.2002. View

Ruoff K . Nutritionally variant streptococci. Clin Microbiol Rev. 1991; 4(2):184-90. PMC: 358190. DOI: 10.1128/CMR.4.2.184. View

Collins M, Lawson P . The genus Abiotrophia (Kawamura et al.) is not monophyletic: proposal of Granulicatella gen. nov., Granulicatella adiacens comb. nov., Granulicatella elegans comb. nov. and Granulicatella balaenopterae comb. nov. Int J Syst Evol Microbiol. 2000; 50 Pt 1:365-369. DOI: 10.1099/00207713-50-1-365. View

Christensen J, Facklam R . Granulicatella and Abiotrophia species from human clinical specimens. J Clin Microbiol. 2001; 39(10):3520-3. PMC: 88382. DOI: 10.1128/JCM.39.10.3520-3523.2001. View

Sapico F, Liquete J, Sarma R . Bone and joint infections in patients with infective endocarditis: review of a 4-year experience. Clin Infect Dis. 1996; 22(5):783-7. DOI: 10.1093/clinids/22.5.783. View

Stein D, Nelson K . Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma. Rev Infect Dis. 1987; 9(5):908-16. DOI: 10.1093/clinids/9.5.908. View

Thomas P, Allal J, Bontoux D, Rossi F, Poupet J, Petitalot J . Rheumatological manifestations of infective endocarditis. Ann Rheum Dis. 1984; 43(5):716-20. PMC: 1001514. DOI: 10.1136/ard.43.5.716. View

Giuliano S, Caccese R, Carfagna P, Vena A, Falcone M, Venditti M . Endocarditis caused by nutritionally variant streptococci: a case report and literature review. Infez Med. 2012; 20(2):67-74. View

Frenkel A, Hirsch W . Spontaneous development of L forms of streptococci requiring secretions of other bacteria or sulphydryl compounds for normal growth. Nature. 1961; 191:728-30. DOI: 10.1038/191728a0. View

10.

Mushtaq A, Greenwood-Quaintance K, Cole N, Kohner P, Ihde S, Strand G . Differential Antimicrobial Susceptibilities of Granulicatella adiacens and Abiotrophia defectiva. Antimicrob Agents Chemother. 2016; 60(8):5036-9. PMC: 4958207. DOI: 10.1128/AAC.00485-16. View

11.

Roggenkamp A, Leitritz L, Baus K, Falsen E, Heesemann J . PCR for detection and identification of Abiotrophia spp. J Clin Microbiol. 1998; 36(10):2844-6. PMC: 105074. DOI: 10.1128/JCM.36.10.2844-2846.1998. View

12.

Kitada K, Okada Y, Kanamoto T, Inoue M . Serological properties of Abiotrophia and Granulicatella species (nutritionally variant streptococci). Microbiol Immunol. 2001; 44(12):981-5. DOI: 10.1111/j.1348-0421.2000.tb02593.x. View

13.

Ohara-Nemoto Y, Kishi K, Satho M, Tajika S, Sasaki M, Namioka A . Infective endocarditis caused by Granulicatella elegans originating in the oral cavity. J Clin Microbiol. 2005; 43(3):1405-7. PMC: 1081294. DOI: 10.1128/JCM.43.3.1405-1407.2005. View

14.

Patri S, Agrawal Y . Granulicatella elegans endocarditis: a diagnostic and therapeutic challenge. BMJ Case Rep. 2016; 2016. PMC: 4769452. DOI: 10.1136/bcr-2015-213987. View

15.

Wilson W, Taubert K, Gewitz M, Lockhart P, Baddour L, Levison M . Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and.... J Am Dent Assoc. 2008; 139 Suppl:3S-24S. DOI: 10.14219/jada.archive.2008.0346. View

16.

Adam E, Siciliano R, Gualandro D, Calderaro D, Issa V, Rossi F . Case series of infective endocarditis caused by Granulicatella species. Int J Infect Dis. 2014; 31:56-8. DOI: 10.1016/j.ijid.2014.10.023. View

17.

Al-Tawfiq J, Kiwan G, Murrar H . Granulicatella elegans native valve infective endocarditis: case report and review. Diagn Microbiol Infect Dis. 2006; 57(4):439-41. DOI: 10.1016/j.diagmicrobio.2006.10.005. View