Streptobacillus moniliformis endocarditis in an HIV-positive patient

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T Rordorf1, C Züger, R Zbinden

  • 1Dept. of Medicine, Cantonal Hospital, Olten, Switzerland.

Infection
|January 4, 2001
PubMed

Insights

Rat bite fever caused by Streptobacillus moniliformis can lead to endocarditis, even in HIV-positive individuals without prior heart conditions. This case highlights successful antibiotic treatment and management of a subsequent fungal infection.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Streptobacillus moniliformis is the primary cause of rat bite fever.
  • Endocarditis is a rare but recognized complication of S. moniliformis infection.
  • Human immunodeficiency virus (HIV) infection can alter disease presentation and complications.

Observation:

  • A case report of an HIV-positive man who developed S. moniliformis endocarditis following a rat bite.
  • The patient had no known predisposing cardiac lesions.
  • The patient experienced a generalized Candida albicans infection post-antibiotic therapy.

Findings:

  • Successful treatment of S. moniliformis endocarditis with a multi-drug intravenous antibiotic regimen including ceftriaxone, gentamicin, and penicillin.
  • Management of a secondary Candida albicans infection with fluconazole.
  • Patient discharge in satisfactory clinical condition.

Implications:

  • This case underscores the importance of considering S. moniliformis endocarditis in patients with relevant exposure history, particularly those who are immunocompromised.
  • Effective antibiotic strategies can lead to favorable outcomes in rare infectious complications.
  • Awareness of potential secondary infections, such as candidiasis, is crucial during treatment of severe bacterial infections in immunocompromised individuals.

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