ro13-9904 and Aortic-Valve-Insufficiency

Topics: Aged; Anti-Bacterial Agents; Aortic Valve; Aortic Valve Insufficiency; Ceftriaxone; Echocardiography, Transesophageal; Endocarditis, Subacute Bacterial; Fatal Outcome; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Male; Shock, Cardiogenic; Streptococcal Infections; Vasculitis, Leukocytoclastic, Cutaneous; Viridans Streptococci

Topics: Anti-Infective Agents; Aortic Valve; Aortic Valve Insufficiency; Aza Compounds; Blindness; Ceftriaxone; Cough; Echocardiography, Transesophageal; Endophthalmitis; Fever; Fluoroquinolones; Hearing Loss, Sensorineural; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Moxifloxacin; Pneumococcal Infections; Quinolines; Streptococcus pneumoniae; Vancomycin; Vision Disorders

The present report describes a very rare case of an aortic homograft valve endocarditis caused by Cardiobacterium hominis. The case was complicated by an agranulocytosis after 3 weeks of antibiotic treatment induced by ceftriaxone. Alternative oral treatment with ciprofloxacin and rifampicin was successful, no surgical intervention was needed and homograft function could be preserved.

Topics: Agranulocytosis; Anti-Bacterial Agents; Aortic Valve; Aortic Valve Insufficiency; Bacteremia; Bioprosthesis; Cardiobacterium; Ceftriaxone; Drug Therapy, Combination; Endocarditis, Bacterial; Follow-Up Studies; Gram-Negative Bacterial Infections; Heart Valve Prosthesis; Humans; Infant, Newborn; Male; Middle Aged; Prosthesis Failure; Recurrence; Reoperation; Transplantation, Homologous

A 67-year-old woman was admitted with aortic valve endocarditis and aortic wall thickening (AWT). Physical examination and laboratory findings yielded infective endocarditis. Echocardiography revealed several small vegetations on the aortic valve, leading to moderate aortic insufficiency together with a small ventricular septal defect. We also became aware of the AWT on and over the aortic root by transesophageal echocardiography (Figure 1). At the one month follow-up period, we also noticed an abscess formation originating from the AWT, which grew into a mature abscess form, day by day (Figure 2). The aortic valve endocarditis, with destruction of the aortic annulus and abscess formation, in this patient, is considered as a grave condition which, essentially, requires an aggressive combined surgical and medical approach. We would like to intimate here with this patient that AWT needs to be considered seriously important in aortic valve endocarditis and, even if the detected vegetations are small, a close follow-up for a possible abscess formation is essential.

Topics: Abscess; Aged; Anti-Bacterial Agents; Aortic Valve; Aortic Valve Insufficiency; Ceftriaxone; Endocarditis, Bacterial; Female; Gentamicins; Heart Valve Prosthesis Implantation; Humans; Penicillin G; Staphylococcal Infections; Streptococcus; Ultrasonography

Topics: Adolescent; Anesthetics, Local; Anti-Bacterial Agents; Aortic Valve Insufficiency; Aspirin; Bardet-Biedl Syndrome; Ceftriaxone; Endocarditis; Gentamicins; Humans; Male; Penicillins; Platelet Aggregation Inhibitors; Procaine; Rheumatic Heart Disease; Risk Factors

Aerococcus urinae is a rarely reported pathogen that often causes mild urinary tract infection (UTI), although serious complications such as endocarditis and septicemia have also been described. The organism may easily be missed or misidentified when using commercial detection systems. A. urinae is resistant to sulfonamides and, therefore, a typical treatment for UTI may be inappropriate. To date, 14 cases of A. urinae infective endocarditis (IE) have been reported, most of which were elderly males with predisposing conditions to UTI. Of these patients, eight died and 50% of survivors had severe neurological problems. The case is reported of blood culture-negative IE in a 69-year-old male. The patient recovered fully after undergoing aortic valve replacement and receiving a nine-day course of intravenous ceftriaxone, followed by peroral cefuroxime for the next 11 weeks. The causative agent was identified from the excised valve by bacterial broad-range PCR and direct sequencing of the 16S rRNA gene.

Topics: Aged; Anti-Bacterial Agents; Aortic Valve Insufficiency; Ceftriaxone; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Heart Valve Prosthesis Implantation; Humans; Male; Streptococcaceae

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation.

Topics: Abscess; Adult; Aortic Valve; Aortic Valve Insufficiency; Bacteremia; Ceftriaxone; Cephalosporins; Endocarditis, Bacterial; Erysipelothrix Infections; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Male

We describe a 66-year-old woman with infective endocarditis due to Cardiobacterium hominis whose condition, complicated by severe aortic regurgitation and congestive heart failure, necessitated aortic valve replacement despite treatment with ceftriaxone followed by ciprofloxacin. The blood isolate of C. hominis produced beta-lactamase and exhibited high-level resistance to penicillin (MIC, >==256 microgram/ml) and reduced susceptibility to vancomycin (MIC, 8 microgram/ml).

Topics: Aged; Aortic Valve; Aortic Valve Insufficiency; beta-Lactamases; Ceftriaxone; Ciprofloxacin; Endocarditis, Bacterial; Female; Gram-Negative Bacterial Infections; Gram-Negative Facultatively Anaerobic Rods; Heart Failure; Heart Valve Prosthesis Implantation; Humans; Microbial Sensitivity Tests; Penicillin Resistance; Penicillins; Taiwan; Vancomycin