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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;

The Canadian Journal of Infectious Diseases = Journal Canadien Des Maladies Infectieuses
|December 27, 2007
PubMed

Insights

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.

Keywords:
EndocarditisGemella speciesPaediatrics

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