Disseminated Rothia kristinae Infection: A Case Highlighting an Emerging Pathogen

Rothia kristinae is usually found in the environment, on normal skin and mucosal surfaces of humans, and there is a limited medical literature available on this organism and its pathogenicity. Our case describes a woman in her early 70's with left hip osteoarthritis presented with generalized weakness, fever, and altered mentation associated with left hip and back pain. Laboratory workup was significant for leukocytosis and elevated inflammatory markers. Blood culture demonstrated Gram-positive cocci, later identified as Rothia kristinae. She was subsequently diagnosed with native aortic valve endocarditis, multilevel discitis, and left hip septic arthritis. She completed 2 weeks of intravenous vancomycin. Treatment was complicated by a drug reaction to vancomycin and switched to linezolid. She developed a left hip abscess and underwent left hip arthroplasty. Follow-up transthoracic echocardiogram showed resolution of infective endocarditis. This case describes the extent of disseminated infection the organism can cause and its pathogenic potential warranting a low threshold for clinicians to initiate treatment.