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Listeria monocytogenes prosthetic valve endocarditis
Abstract:
Listeria monocytogenes is a rare cause of prosthetic valve endocarditis and in all of the four reported cases has occurred as a late complication. Bacteriologic cure of the infection has been obtained in all reported patients, using a standard regimen of either penicillin or penicillin and an aminoglycoside. The two deaths were associated with Starr-Edwards prostheses in the aortic position and have been attributed to embolic phenomena occurring after bacteriologic sterilization of the infected valve.
Insights
Listeria monocytogenes rarely causes prosthetic valve endocarditis, typically as a late complication. While antibiotic treatment achieves bacterial cure, embolic events can still be fatal, especially with aortic valve prostheses.
Area of Science:
- Infectious Diseases
- Cardiology
- Medical Microbiology
Background:
- Prosthetic valve endocarditis (PVE) is a serious complication following cardiac valve replacement surgery.
- Listeria monocytogenes is an uncommon pathogen implicated in PVE, often presenting as a late-onset infection.
Observation:
- This report details four cases of PVE caused by Listeria monocytogenes.
- All reported cases presented as late complications, occurring after initial valve replacement.
- The causative agent was identified as Listeria monocytogenes in all instances.
Findings:
- Bacteriologic cure was achieved in all patients treated with standard antibiotic regimens, including penicillin or penicillin plus an aminoglycoside.
- Two fatalities were recorded, both associated with Starr-Edwards aortic prostheses.
- Deaths were attributed to embolic phenomena, occurring despite successful bacteriologic sterilization of the infected valve.
Implications:
- Effective antibiotic therapy can eradicate Listeria monocytogenes from infected prosthetic valves.
- Embolic complications remain a significant risk, even after successful infection control, particularly in patients with specific types of aortic prostheses.
- This highlights the need for vigilant monitoring and potential anticoagulation strategies in patients with PVE caused by Listeria monocytogenes.