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Legionella endocarditis: A case report and review
Andrea Teira1, Juan Sánchez1, Ignacio Santiago1
1Service of Cardiology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
Summary
Legionella bacteria can cause heart valve infections (endocarditis), particularly in those with prosthetic valves. Early diagnosis using molecular methods improves the favorable prognosis for this rare condition.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Legionella species are an uncommon cause of bacterial endocarditis.
- Prosthetic valve presence is a significant risk factor for Legionella endocarditis.
Observation:
- A case of a 63-year-old man with a prosthetic aortic valve who developed persistent fever and monoarthritis, ultimately found to have Legionella endocarditis diagnosed via 16S-rRNA PCR.
- The patient experienced a perivalvular abscess and unfortunately died during surgical intervention.
Findings:
- A review of 20 reported cases indicates that Legionella endocarditis, while rare, has a favorable prognosis with or without surgical valve replacement, with an overall mortality of less than 10%.
- Molecular diagnostic techniques, such as 16S-rRNA PCR, are crucial for identifying Legionella in cases with negative blood cultures.
Implications:
- Legionella endocarditis frequently necessitates surgical intervention.
- Molecular diagnostic methods are poised to become the standard for diagnosing Legionella endocarditis.
- Despite its rarity, prompt diagnosis and appropriate treatment contribute to a good patient outcome.
