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Staphylococcus lugdunensis Endocarditis Complicated by Embolism in an 18-Year-Old Woman with Mitral Valve Prolapse

Rosaria Pecoraro1, Antonino Tuttolomondo, Gaspare Parrinello

  • 1Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, 90127 Palermo, Italy.

Case Reports in Infectious Diseases
|February 21, 2013
PubMed

Insights

Staphylococcus lugdunensis endocarditis occurred in a young woman with mitral valve prolapse. The infection led to a septic embolus, requiring surgical intervention for both the valve and arterial thrombosis.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CNS) known to cause severe infections.
  • Mitral valve prolapse (MVP) is an increasingly recognized predisposing factor for infective endocarditis.
  • Native valve endocarditis caused by S. lugdunensis is less common but can be aggressive.

Purpose of the Study:

  • To report a rare case of Staphylococcus lugdunensis native mitral valve endocarditis in a young patient with mitral valve prolapse.
  • To highlight the potential for septic embolization and its management in S. lugdunensis endocarditis.
  • To emphasize the importance of early diagnosis and multidisciplinary management of infective endocarditis.

Main Methods:

  • Case report of an 18-year-old female patient.
  • Transthoracic echocardiogram for cardiac evaluation.
  • Blood cultures for microbial identification.
  • Lower limb arterial Doppler ultrasound for suspected embolism.
  • Surgical intervention including embolectomy and valve repair/resection.

Main Results:

  • The patient presented with fever and was diagnosed with S. lugdunensis endocarditis on a native mitral valve with MVP.
  • Echocardiography revealed a large vegetation on the anterior mitral valve leaflet.
  • Septic embolus to the right common iliac artery occurred despite antibiotic therapy, necessitating embolectomy.
  • S. lugdunensis was isolated from the septic embolus, confirming the source of embolism.
  • Successful surgical management involved valve debridement and resection.

Conclusions:

  • Staphylococcus lugdunensis can cause severe native valve endocarditis, even in young individuals with underlying cardiac abnormalities like MVP.
  • Septic embolization is a significant complication that requires prompt recognition and management.
  • Multidisciplinary care, including infectious disease, cardiology, and cardiac surgery, is crucial for optimal outcomes in infective endocarditis.

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