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[Lactobacillus casei endocarditis after aortic valve prosthesis].

B Meier, E Fischer, R Lüthy

Schweizerische Medizinische Wochenschrift

|April 25, 1981

Summary

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This case report details successful conservative management of Lactobacillus casei endocarditis in a patient with a prosthetic aortic valve. Prompt antibiotic therapy avoided the need for artificial valve replacement, with the patient remaining symptom-free.

Area of Science:

Cardiology
Infectious Diseases
Microbiology

Background:

Lactobacillus casei endocarditis is rare, particularly in patients with prosthetic heart valves.
Prosthetic valve endocarditis often necessitates surgical intervention.

Observation:

A 53-year-old patient presented with endocarditis caused by Lactobacillus casei, nine years post-aortic valve replacement with a Björk-Shiley graft.
Diagnosis was delayed due to challenges in identifying the causative organism.

Findings:

Conservative management with penicillin G and gentamicin was initiated approximately six weeks after symptom onset.
The antibiotic regimen proved effective, obviating the need for repeat prosthetic valve surgery.
The patient remained asymptomatic seven months after completing therapy.

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Implications:

This case suggests that conservative, antibiotic-only management may be a viable option for select cases of Lactobacillus endocarditis involving prosthetic valves.
Highlights the importance of considering unusual pathogens in prosthetic valve endocarditis.
Contributes to the limited literature on non-surgical management of prosthetic valve endocarditis.