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Aortic root replacement in a patient with vancomycin-resistant Enterococcus faecium endocarditis and leukemia
1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55902, USA.
Chest
|November 20, 2001
Summary
Vancomycin-resistant Enterococcus faecium endocarditis is a rare infection, particularly in patients with hairy-cell leukemia. This case highlights a successful treatment approach involving surgery and combination antibiotic therapy.
Area of Science:
- Infectious Diseases
- Cardiology
- Hematology
Background:
- Vancomycin-resistant Enterococcus faecium (VRE) endocarditis is infrequent and typically affects immunocompromised individuals.
- Hairy-cell leukemia is a rare B-cell malignancy associated with impaired immune function.
Observation:
- A patient with hairy-cell leukemia presented with severe aortic insufficiency, indicative of infective endocarditis.
- The causative agent was identified as vancomycin-resistant Enterococcus faecium.
Findings:
- The patient underwent successful aortic root replacement using a cryopreserved aortic homograft.
- A combination antibiotic regimen including quinupristin/dalfopristin, ampicillin, and gentamicin was administered.
Implications:
- This case demonstrates a feasible management strategy for VRE endocarditis in immunocompromised patients with hematologic malignancies.
- Aggressive treatment combining surgical intervention and targeted antimicrobial therapy can lead to favorable outcomes.
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