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[A protracted course in Cardiobacterium hominis endocarditis]
Deutsche Medizinische Wochenschrift (1946)
|May 17, 1991
Summary
A rare bacterial infection, Cardiobacterium hominis, caused aortic valve endocarditis in a 69-year-old man. Despite aggressive treatment, persistent anemia and inflammation suggest immune complex involvement.
Area of Science:
- Infectious Diseases
- Cardiology
- Hematology
Background:
- A 69-year-old male presented with unexplained systemic symptoms including elevated erythrocyte sedimentation rate (ESR), hemolytic anemia, reduced exercise tolerance, backache, and weight loss.
- Initial diagnostic workup including radiological, biochemical, and endoscopic examinations failed to identify the underlying cause.
Observation:
- Blood cultures revealed the rare Gram-negative organism Cardiobacterium hominis, a known cause of endocarditis.
- Echocardiography confirmed endocarditis of the aortic valve with significant regurgitation.
Findings:
- Despite a prolonged course of high-dose antibiotics (Penicillin G and Gentamicin) and treatment for chronic periodontitis, the patient's anemia, hemolysis, and elevated ESR persisted for over a year.
- Subsequent blood cultures were negative, indicating the resolution of active bacteremia.
Implications:
- The persistent inflammatory and hematological abnormalities suggest a post-infectious immune-complex mediated process as the likely cause.
- This case highlights the diagnostic challenges and potential long-term sequelae of rare bacterial endocarditis, even after apparent microbiological cure.