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[Endocarditis caused by rare Gram-positive bacteria: investigate for gastrointestinal disorders]

Julia Kovaleva1, Leo G Gerhards, A V M Lieke Möller

  • 1Universitair Medisch Centrum Groningen, afd. Medische Microbiologie, Groningen, the Netherlands. j.kovaleva@umcg.nl

Nederlands Tijdschrift Voor Geneeskunde
|May 22, 2012
PubMed

Insights

Rare bacteria like Gemella haemolysans and Streptococcus equinus can cause endocarditis, often linked to gastrointestinal issues. Investigating the GI tract is crucial for diagnosing these rare infections.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Gastroenterology

Background:

  • Gemella haemolysans, Streptococcus equinus (Streptococcus bovis group), and Tropheryma whipplei are rare Gram-positive bacteria.
  • These microorganisms are infrequently associated with infective endocarditis.
  • A potential link exists between these bacterial infections and gastrointestinal disorders.

Observation:

  • This report details three cases of infective endocarditis caused by G. haemolysans, S. equinus, and T. whipplei.
  • G. haemolysans and S. equinus were identified through blood cultures.
  • T. whipplei was diagnosed via molecular typing of cardiac valve tissue.

Findings:

  • Endoscopic evaluation revealed a colonic carcinoma in the patient with G. haemolysans endocarditis.
  • Diverticulosis was identified in the patient with S. equinus endocarditis.
  • No gastrointestinal abnormalities were found in the patient with T. whipplei endocarditis, though Whipple's disease cannot be excluded.

Implications:

  • The association between endocarditis caused by these rare bacteria and gastrointestinal disorders warrants further investigation.
  • Gastrointestinal tract examination is recommended for patients with endocarditis due to G. haemolysans, S. equinus, or T. whipplei when no other bacteremia source is evident.
  • Early identification of a gastrointestinal focus may improve patient outcomes for these rare endocarditis cases.

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