[Neisseria Sicca endocarditis disclosed by multiple organ failure syndrome]

The authors report a case of Neisseria sicca endocarditis presenting with multiple organ failure in a 33 year old intravenous drug user. The diagnosis was confirmed by transthoracic and transoesophageal echocardiography showing vegetations on the aortic valve and three blood cultures positive for Neisseria Sicca. Massive aortic regurgitation occurred on the 4th day. The patient died of complications of intracerebral haematomas before surgical intervention. Contrary to pathogenic Neisseria gonorrhoeae and meningitides, saprophytic Neisseria, including Neisseria sicca, are commensal organisms of the upper respiratory tract. They are exceptionally rare causes of endocarditis. A review of the literature from the era of antibiotic therapy, found about thirty cases of saprophytic Neisseria endocarditis of which only five were due to Neisseria sicca. The clinical characteristics were the young age, the mainly left heart valve disease and the high incidence of cerebrovascular accidents. The originality of this case was the exceptionally rare involvement of this organism and the multiplicity of the extracardiac manifestations, especially renal and neurological.