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Bacillus cereus endocarditis involving a prosthetic valve.

H A Oster, T Q Kong

    Southern Medical Journal
    |April 1, 1982
    PubMed
    Summary

    Late-onset endocarditis caused by Bacillus cereus is rare, especially in patients with prosthetic heart valves. This case highlights successful combination antibiotic therapy and valve replacement for a Bacillus cereus prosthetic valve endocarditis.

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    Area of Science:

    • Infectious Diseases
    • Cardiology
    • Microbiology

    Background:

    • Prosthetic valve endocarditis (PVE) is a serious complication following cardiac valve replacement surgery.
    • Late-onset PVE, occurring more than one year after implantation, presents unique diagnostic and therapeutic challenges.
    • Bacillus cereus is an uncommon pathogen in infective endocarditis, particularly in the context of prosthetic valves.

    Observation:

    • A 55-year-old male patient presented with late-onset endocarditis.
    • The patient had a history of Carpentier-Edwards heterograft valve implantation.
    • Infecting organism identified as Bacillus cereus.

    Findings:

    • Combination antibiotic therapy with gentamicin and clindamycin was guided by minimal bactericidal concentration testing.
    • Surgical intervention involving valve replacement was necessitated by a significant paravalvular leak.
    • The patient achieved clinical resolution with no recurrence after a six-week course of antibiotics.

    Implications:

    • This case underscores the importance of considering Bacillus cereus in late-onset PVE, even with prosthetic valves.
    • Effective management may involve a combination of targeted antimicrobial therapy and surgical intervention.
    • Successful treatment outcomes are achievable with appropriate therapeutic strategies.

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