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Neisseria meningitidis native valve endocarditis. A case report
1Department of Medicine and Cardiology, Garcia de Orta Hospital, Almada. fg.ijg@mail.telepac.pt
Abstract:
The so-called nonpathogenic neisseriae are common inhabitants of the upper respiratory tract in humans and are not usually regarded as pathogens. Neisseria meningitidis on the contrary may cause severe disease. These organisms are an uncommon cause of infective endocarditis. The authors report a case of a 64 year-old male, type II diabetic, previously asymptomatic, admitted to hospital because of fever, aphasia and right hemi-paresis. A systolic murmur was heard at the cardiac apex, and three blood cultures were positive for Neisseria meningitidis. The echocardiogram showed a vegetation on the posterior leaflet of the mitral valve, allowing the diagnosis of meningococcal endocarditis. The patient's clinical condition improved on intravenous penicillin therapy, and regression of fever, disappearance of the neurological signs and of the mitral valve vegetation were observed.
Insights
Neisseria meningitidis, a bacterium not typically causing heart infections, was found to cause endocarditis in a diabetic patient. Prompt penicillin treatment led to recovery, resolving fever, neurological symptoms, and valve vegetation.
Area of Science:
- Infectious Diseases
- Cardiology
- Neurology
Background:
- Nonpathogenic Neisseria species are common upper respiratory tract commensals.
- Neisseria meningitidis is primarily known for causing meningitis and sepsis.
- Infective endocarditis is an uncommon manifestation of Neisseria meningitidis infection.
Observation:
- A 64-year-old male with type II diabetes presented with fever, aphasia, and right hemiparesis.
- Cardiac examination revealed a systolic murmur, and blood cultures were positive for Neisseria meningitidis.
- Echocardiography identified a vegetation on the mitral valve posterior leaflet.
Findings:
- The patient was diagnosed with meningococcal endocarditis.
- Intravenous penicillin therapy resulted in clinical improvement.
- Resolution of fever, neurological deficits, and mitral valve vegetation was observed.
Implications:
- This case highlights Neisseria meningitidis as a potential cause of infective endocarditis, even in immunocompetent individuals.
- Early diagnosis and appropriate antibiotic treatment are crucial for favorable outcomes.
- Further research may elucidate the specific mechanisms and risk factors for meningococcal endocarditis.