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Endocarditis due to Streptococcus faecalis with high-level resistance to gentamicin
1Department of Internal Medicine, University of California, Davis.
Reviews of Infectious Diseases
|March 1, 1989
Summary
High-level gentamicin-resistant Streptococcus faecalis can cause endocarditis. Early diagnosis and tailored antimicrobial therapy are crucial for effective treatment of this challenging infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Cardiology
Background:
- Reports of Streptococcus faecalis exhibiting high-level gentamicin resistance (HLGR) are emerging.
- Endocarditis caused by HLGR Streptococcus faecalis has not been previously documented.
Observation:
- This article details two cases of endocarditis.
- Both cases were caused by HLGR Streptococcus faecalis.
- Both patients presented with atypical symptoms.
Findings:
- High-level gentamicin resistance in Streptococcus faecalis is a potential cause of endocarditis.
- Atypical presentations necessitate a high index of suspicion for endocarditis.
- Microbiological evaluation is key to selecting appropriate antimicrobial regimens.
Implications:
- Clinicians should consider HLGR Streptococcus faecalis in suspected endocarditis cases, especially with unusual presentations.
- Accurate and timely laboratory diagnostics are essential for guiding treatment decisions.
- This finding highlights the need for vigilance regarding antimicrobial resistance in infective endocarditis.