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Campylobacter fetus endocarditis: two case reports and review
D C Farrugia1, S J Eykyn, E G Smyth
1Queen Mary's Hospital, Sidcup, Kent, United Kingdom.
Insights
Campylobacter fetus endocarditis is rare but serious, affecting native and prosthetic aortic valves. Prompt valve replacement ensured full recovery in two complex cases.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Campylobacter fetus is an uncommon bacterial pathogen in humans.
- It has a predilection for causing severe vascular infections, including endocarditis and thrombophlebitis.
- Endocarditis is an infection of the heart lining or valves.
Observation:
- Two cases of Campylobacter fetus endocarditis are presented.
- Case 1: A 60-year-old woman with a native bicuspid aortic valve.
- Case 2: A 76-year-old woman with a prosthetic aortic valve; the oldest reported patient with this condition.
Findings:
- No clear source of infection was identified in either case.
- Both patients experienced hemodynamic deterioration despite antibiotic treatment.
- Surgical aortic valve replacement was required for recovery.
Implications:
- Campylobacter fetus, though rare, should be considered in severe endocarditis, particularly aortic valve involvement.
- This organism's tendency to affect vascular endothelium highlights its potential for severe systemic illness.
- The successful management underscores the importance of considering surgical intervention in refractory cases.
Abstract:
We report two cases of Campylobacter fetus endocarditis. The first case involved a bicuspid native aortic valve in a 60-year-old woman, and the second involved a prosthetic aortic valve in a 76-year-old woman. No source of infection was identified in either case. Despite antibiotic therapy, hemodynamic deterioration necessitated valve replacement; both patients recovered completely. C. fetus is an uncommon cause of human infection but may be responsible for severe illnesses such as endocarditis and thrombophlebitis because of its tendency to attack the vascular endothelium. Review of the literature revealed 21 cases of endocarditis caused by this organism, usually involving the aortic valve. To our knowledge, there are only two reported cases of prosthetic valve endocarditis. Our second patient is the oldest one encountered so far with this condition.