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Case of aortic endocarditis caused by Lactobacillus casei
L Zé-Zé1, R Tenreiro1, A Duarte1
1Departamento de Biologia Vegetal e Centro de Genética e Biologia Molecular, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal 2Departamento de Microbiologia, Faculdade de Farmácia, Universidade de Lisboa, 1649-019 Lisboa, Portugal 3,5Laboratório de Bacteriologia3 and Departamento de Doenças Infecto-Contagiosas5, Hospital de Santa Maria, 1649-035 Lisboa, Portugal 4Laboratório de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal.
Lactobacillus aortic valve endocarditis is reported in an immunocompetent patient following dental work and high yogurt intake. The infection, identified as Lactobacillus casei, was confirmed through blood, bone marrow, and aortic valve cultures.
Area of Science:
- Cardiology
- Infectious Diseases
- Microbiology
Background:
- Lactobacillus species are common commensals, typically associated with gastrointestinal and genitourinary health.
- Infective endocarditis is a serious infection of the heart valves, often caused by bacteria.
- While rare, Lactobacillus endocarditis can occur, particularly in individuals with predisposing factors.
Observation:
- A case of Lactobacillus aortic valve endocarditis is presented in a 53-year-old immunocompetent male.
- The patient had a history of rheumatic fever and recently underwent a dental extraction.
- Dietary habits included high daily consumption of yogurt.
Findings:
- Blood, bone marrow cultures, and the explanted aortic valve were positive for Lactobacillus.
- The causative agent was identified as Lactobacillus casei using 16S rDNA sequencing.
- This case highlights a potential link between Lactobacillus endocarditis, dental procedures, and probiotic-rich diets.
Implications:
- This case underscores the importance of considering Lactobacillus species in the differential diagnosis of infective endocarditis, even in immunocompetent individuals.
- The findings suggest that dental procedures and high probiotic intake may be potential risk factors for Lactobacillus endocarditis.
- Further research is warranted to elucidate the pathogenesis and identify optimal management strategies for Lactobacillus endocarditis.