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[Endocarditis in heart valve bioprosthesis caused by Cardiobacterium hominis]
M V De Resende1, A J Mansur, F Tarasoutchi
1Instituto do Coraçáo do Hospital das Clínicas, FMUSP.
Insights
A patient with Cardiobacterium hominis endocarditis on a prosthetic mitral valve successfully recovered after 42 days of antibiotics and valve replacement surgery. She remains asymptomatic, highlighting effective treatment for prosthetic valve endocarditis.
Area of Science:
- Infectious Diseases
- Cardiology
- Cardiac Surgery
Background:
- Prosthetic valve endocarditis (PVE) poses a significant clinical challenge, often requiring complex management strategies.
- Cardiobacterium hominis is a rare but potential pathogen causing infective endocarditis, particularly in patients with prosthetic heart valves.
Observation:
- A 36-year-old female presented with clinical signs of endocarditis on a mitral valve prosthesis.
- Blood cultures eventually identified Cardiobacterium hominis as the causative agent after seven days of incubation.
- The patient developed heart failure refractory to initial medical management.
Findings:
- Combined antibiotic therapy with crystalline penicillin and amikacin was administered for 42 days.
- Surgical intervention, including aortic valve replacement with a bovine pericardium prosthesis, was performed on day 18 of antibiotic treatment.
- The patient achieved a favorable outcome, remaining asymptomatic at seven-month follow-up.
Implications:
- This case underscores the importance of prolonged antibiotic courses and timely surgical intervention in managing PVE caused by unusual pathogens.
- Successful treatment highlights the efficacy of a multidisciplinary approach involving infectious disease specialists and cardiac surgeons.
- The use of bovine pericardium for valve replacement demonstrated a viable option in this complex endocarditis scenario.
Abstract:
A 36-year-old female patient developed Cardiobacterium hominis endocarditis on a mitral valve prosthesis. The etiologic agent was identified in the seventh day of incubation of the blood cultures specimens. Crystalline penicillin (18.10(6) UI daily) and amikacin (800 mg daily) were administered for 42 days. Surgical treatment for heart failure unresponsive to medical treatment was carried on in the eighteenth day of antibiotic therapy. A bovine pericardium prosthesis was inserted. The patient was discharged and is asymptomatic after seven months.