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Legionella micdadei prosthetic valve endocarditis
D Park1, A Pugliese, B A Cunha
1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501.
Abstract:
Legionella usually causes pneumonia, but occasionally is in the differential diagnosis of "culture negative endocarditis" which sometimes involves prosthetic heart valves. Legionella prosthetic valve endocarditis is nearly always due to Legionella pneumophila and its clinical presentation is indistinguishable from other causes of prosthetic valve endocarditis. Diagnosis of Legionella prosthetic valve endocarditis is by recovery of the organism from the blood, demonstration or isolation of the organism from the prosthetic heart valve, or by persistently high Legionella titers which are extremely elevated in prosthetic valve endocarditis compared to Legionella pneumonia. We believe this is the first case reported of prosthetic valve endocarditis caused by Legionella micdadei, and the first case of Legionella prosthetic valve endocarditis with microscopic hematuria.
Insights
This study reports the first case of prosthetic valve endocarditis caused by Legionella micdadei, a rare infection presenting with microscopic hematuria. This finding expands the understanding of Legionella infections in cardiac surgery patients.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Legionella typically causes pneumonia but can be implicated in culture-negative endocarditis, particularly involving prosthetic heart valves.
- Legionella prosthetic valve endocarditis is usually caused by Legionella pneumophila and clinically resembles other forms of the condition.
- Diagnosis relies on organism detection in blood or valve tissue, or significantly elevated Legionella titers.