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Infective endocarditis complicated with progressive heart failure due to beta-lactamase-producing Cardiobacterium
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Insights
A rare case of infective endocarditis caused by Cardiobacterium hominis in a woman required aortic valve replacement. The bacteria showed resistance to common antibiotics, highlighting treatment challenges.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Infective endocarditis (IE) is a serious infection of the heart valves.
- Cardiobacterium hominis is a rare cause of IE, often associated with specific risk factors.
- Antibiotic resistance in IE pathogens poses significant treatment challenges.
Observation:
- A 66-year-old woman presented with IE caused by Cardiobacterium hominis.
- Her condition was complicated by severe aortic regurgitation and congestive heart failure.
- Despite treatment with ceftriaxone and ciprofloxacin, aortic valve replacement was necessary.
Findings:
- The blood isolate of Cardiobacterium hominis produced beta-lactamase.
- The organism exhibited high-level penicillin resistance (MIC >==256 µg/mL).
- Reduced susceptibility to vancomycin was observed (MIC = 8 µg/mL).
Implications:
- This case underscores the importance of antimicrobial susceptibility testing for C. hominis.
- Treatment strategies for C. hominis IE may need to consider beta-lactamase production and resistance patterns.
- Aortic valve replacement may be required in severe cases despite appropriate antibiotic therapy.
Abstract:
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).