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A Challenge of COVID-19: Associated Infective Endocarditis with Streptococcus gordonii in a Young Immunocompetent

Manuela Arbune1, Alina-Viorica Iancu2, Gabriela Lupasteanu3

  • 1Clinical Department, Medicine and Pharmacy Faculty, Dunarea de Jos University of Galati, 800008 Galati, Romania.

Medicina (Kaunas, Lithuania)
|December 24, 2021
PubMed

Insights

COVID-19 complicates infective endocarditis (IE) diagnosis. This case highlights how COVID-19 may alter the microbiome, increasing IE risk from commensal bacteria like Streptococcus gordonii.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • The COVID-19 pandemic presents diagnostic challenges for infective endocarditis (IE).
  • Nonspecific symptoms of coronaviral infections can mask or mimic IE manifestations.
  • Early identification and treatment of IE are crucial for patient outcomes.

Observation:

  • A young patient with persistent fever and systemic symptoms, post-COVID-19 pneumonia, was investigated.
  • Initial symptoms were attributed to COVID-19, delaying IE diagnosis.
  • Blood cultures revealed Streptococcus gordonii, and aortic valve vegetations confirmed IE.

Findings:

  • Infective endocarditis (IE) co-occurred with COVID-19 infection.
  • Streptococcus gordonii, a dental biofilm commensal, was identified as the causative agent.
  • The patient achieved favorable outcomes after six weeks of antibiotic therapy.

Implications:

  • COVID-19 may influence the human microbiome, potentially increasing the virulence of commensal organisms.
  • This alteration could represent a risk factor for native valve infective endocarditis (IE) pathogenesis.
  • Clinicians must maintain a high index of suspicion for IE in patients with persistent febrile syndromes, even with concurrent COVID-19.

Keywords:
COVID-19Streptococcus gordoniiinfectious endocarditisoral microbiome

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