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Native valve endocarditis caused by dysgonic fermenter type 2 bacilli
1Section of General Medicine, Veterans Administration Medical Center, Houston, TX 77030.
The American Journal of the Medical Sciences
|July 1, 1988
Summary
A rare gram-negative bacillus, Dysgonic Fermenter type 2 (DF-2), caused subacute endocarditis in an alcoholic patient with dog exposure. Despite initial antibiotic success, residual valve damage required surgery, highlighting potential long-term complications.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- * Chronic alcoholism is a risk factor for various infections.
- * Endocarditis is inflammation of the heart lining, often affecting valves.
- * Dysgonic Fermenter type 2 (DF-2) is an uncommon gram-negative bacillus.
Observation:
- * A chronic alcoholic with dog contact developed subacute tricuspid endocarditis.
- * The causative agent was identified as DF-2.
- * The patient initially responded to penicillin therapy but later developed congestive heart failure.
Findings:
- * Recurrent pulmonary emboli were noted.
- * Tricuspid valvulectomy was required due to residual valve damage.
- * No active infection was found during surgery, indicating a bacteriologic cure.
Implications:
- * DF-2 endocarditis can lead to significant residual valve damage despite successful antibiotic treatment.
- * Alcoholism and exposure to animals (dogs) are potential risk factors for DF-2 infection.
- * Surgery may be necessary for valve repair or replacement in endocarditis cases, irrespective of the microbial cause.