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Gemella bergeriae endocarditis in a boy.

Latania K Logan1, Xiaotian Zheng, Stanford T Shulman

  • 1Division of Infectious Diseases, Children's Memorial Hospital, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60614, USA. llogan@childrensmemorial.org

The Pediatric Infectious Disease Journal
|January 5, 2008
PubMed
Summary
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This study reports the first pediatric case of Gemella bergeriae endocarditis in a teen with congenital heart disease. Diagnosis required 16S rRNA gene sequencing for accurate identification of the rare bacterial cause.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Microbiology

Background:

  • Tetralogy of Fallot and pulmonary atresia are complex congenital heart defects requiring lifelong management.
  • Bacterial endocarditis is a serious infection of the heart valves, often associated with underlying cardiac abnormalities.
  • Gemella bergeriae is a rare pathogen, infrequently implicated in human infections, particularly in pediatric cases.

Observation:

  • A 15-year-old male with pre-existing tetralogy of Fallot and pulmonary atresia presented with constitutional symptoms including weight loss, chills, and cold intolerance.
  • Blood cultures identified Gram-positive cocci that were initially challenging to speciate using standard Lancefield grouping methods.
  • Clinical presentation suggested infective endocarditis, necessitating further microbiological investigation.

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Findings:

  • The causative agent was identified as Gemella bergeriae through advanced molecular techniques, specifically 16S rRNA gene sequencing.
  • This represents the first documented pediatric case of endocarditis caused by Gemella bergeriae.
  • The organism's unusual presentation and difficulty in initial typing highlight diagnostic challenges.

Implications:

  • This case expands the known spectrum of Gemella bergeriae infections in pediatric patients with complex congenital heart disease.
  • It underscores the importance of utilizing molecular methods like 16S rRNA sequencing for accurate identification of fastidious or unusual bacterial pathogens.
  • Early and precise diagnosis is crucial for timely and effective management of endocarditis in immunocompromised or structurally at-risk pediatric populations.