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Gemella species endocarditis in a child
L K Purcell1, J P Finley, R Chen
1Department of Pediatrics, Dalhousie University and the IWK Grace Health Centre, Halifax, Nova Scotia;
Summary
Gemella bacteria can cause severe illness. This case study details the successful treatment of endocarditis in a pediatric patient with congenital heart disease caused by Gemella species.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- The genus Gemella comprises bacteria capable of causing serious systemic infections.
- Endocarditis, an infection of the heart lining, can be life-threatening, particularly in individuals with underlying cardiac conditions.
Purpose of the Study:
- To report a successfully treated case of Gemella-induced endocarditis in a pediatric patient with congenital heart disease.
- To highlight the diagnostic and therapeutic challenges associated with Gemella infections.
Main Methods:
- Clinical presentation and echocardiographic findings of a 12-year-old girl with endocarditis were documented.
- Antimicrobial susceptibility testing guided the treatment regimen.
- Attempts were made to identify the Gemella species through laboratory analysis.
Main Results:
- The patient presented with symptoms including cough, fatigue, and decreased appetite, without fever.
- Echocardiography revealed severe mitral insufficiency, mitral valve vegetations, and cardiac chamber enlargement.
- Initial treatment with vancomycin was followed by the addition of gentamicin to resolve persistent bacteremia, with subsequent completion of therapy using penicillin G and gentamicin.
Conclusions:
- Gemella species can cause severe endocarditis, even in pediatric patients with congenital heart disease.
- Multidrug antimicrobial therapy may be required for successful treatment.
- Accurate species identification of Gemella isolates can be challenging and requires further investigation.
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