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Native-valve endocarditis caused by Staphylococcus lugdunensis

M P Lessing1, D W Crook, I C Bowler

  • 1Department of Medical Microbiology, John Radcliffe, Oxford Radcliffe Hospital, UK.

QJM : Monthly Journal of the Association of Physicians
|November 1, 1996
PubMed
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Staphylococcus lugdunensis causes destructive native-valve endocarditis, often requiring urgent aortic valve replacement. A history of vasectomy and inguinal skin breaks preceded endocarditis in these cases.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Coagulase-negative staphylococci (CoNS) account for approximately 5% of native-valve endocarditis (NVE).
  • Staphylococcus lugdunensis, a specific CoNS species, is increasingly recognized for causing severe NVE with significant mortality.
  • Native-valve endocarditis necessitates prompt diagnosis and intervention to prevent severe complications.

Observation:

  • This report details four consecutive cases of definitive Staphylococcus lugdunensis NVE, diagnosed using the Duke criteria.
  • All affected patients presented with severe aortic valve involvement.
  • A notable commonality among these patients was a preceding history of vasectomy and associated inguinal skin trauma.

Findings:

  • All four patients with Staphylococcus lugdunensis NVE required emergent aortic valve replacement within 1-5 days of hospital admission.

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  • Prompt surgical intervention led to successful recovery in all reported cases.
  • The study highlights a potential association between vasectomy, inguinal skin breaks, and the subsequent development of S. lugdunensis endocarditis.

    • Implications:

    • Staphylococcus lugdunensis should be considered a significant pathogen in native-valve endocarditis, particularly when associated with severe valve destruction.
    • The findings suggest a possible route of S. lugdunensis inoculation via procedures like vasectomy, leading to endocarditis.
    • Further research is warranted to elucidate the specific mechanisms and risk factors linking urogenital procedures to S. lugdunensis NVE.