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[Endocarditis caused by Lactobacillus].

J C Urkijo1, M Montejo, M F Mendoza

  • 1Servicio de Medicina Interna, Hospital de Cruces, Universidad del País Vasco, Bilbao.

Enfermedades Infecciosas Y Microbiologia Clinica
|January 1, 1992
PubMed
Summary
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Lactobacillus endocarditis is rare and challenging to treat, often requiring specific antibiotic sensitivity testing. This case highlights successful treatment with clindamycin and gentamicin for a resistant strain in a penicillin-allergic patient.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Lactobacillus endocarditis is an uncommon infection.
  • It typically presents with a subacute course and is difficult to treat.
  • Achieving complete recovery can be challenging, even with appropriate antimicrobial therapy.

Observation:

  • A rare case of Lactobacillus endocarditis is presented in a patient with a history of penicillin allergy.
  • The causative Lactobacillus strain exhibited resistance to vancomycin, a key antibiotic for treating resistant infections.
  • The patient's clinical presentation was characterized by a subacute course, indicating a prolonged and insidious infection.

Findings:

  • Successful treatment was achieved using a combination of clindamycin and gentamicin.

Related Experiment Videos

  • This therapeutic approach was effective despite the vancomycin-resistant nature of the Lactobacillus strain.
  • The patient's allergy to penicillin necessitated alternative antibiotic choices.

    • Implications:

    • This case underscores the critical importance of performing antibiotic sensitivity testing for Lactobacillus endocarditis.
    • Evaluating antibiotic tolerance is crucial for selecting an optimal and effective treatment strategy.
    • The findings suggest clindamycin and gentamicin as a viable therapeutic option for vancomycin-resistant Lactobacillus endocarditis, particularly in penicillin-allergic individuals.