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[Mitral valve endocarditis caused by Erysipelothrix rhusiopathiae]
J P Heidrich1, M Stahl, R Dittmann
1Institut für Medizinische Mikrobiologie und Hygiene, Medizinische Universität zu Lübeck. heidrich@medinf.mu-luebeck.de
Deutsche Medizinische Wochenschrift (1946)
|May 12, 2001
Summary
This case report highlights an unusual systemic Erysipelothrix rhusiopathiae infection presenting as endocarditis. Farmers and other high-risk individuals should be considered for this bacterium in endocarditis diagnoses.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- A 67-year-old woman presented with prolonged fever, arthralgia, and catarrh, later developing abdominal pain after ibuprofen use.
- Initial examinations, including cardiac and pulmonary auscultation, electrocardiography, and echocardiography, revealed no significant abnormalities.
Observation:
- Gastroscopy identified acute gastritis and duodenitis with Helicobacter pylori, which initially responded to eradication therapy.
- Following antibiotic cessation, the patient developed severe endocarditis with mitral regurgitation, indicating a persistent or new infection.
Findings:
- Blood cultures isolated Erysipelothrix rhusiopathiae, confirmed by both conventional and molecular methods.
- Successful treatment involved a six-week course of parenteral ampicillin and subsequent mitral valve replacement.
Implications:
- This case underscores the importance of considering Erysipelothrix rhusiopathiae in the differential diagnosis of endocarditis, particularly in high-risk occupational groups.
- Early recognition and appropriate antimicrobial therapy are crucial for managing this rare but serious infection.