[Acute aortic insufficiency following endocarditis due to infection with Campylobacter fetus subspecies fetus].
A 50-year-old male alcoholic addict, examined because of diarrhoea with fever was found to have Campylobacter jejuni in blood and stool cultures. After administration of broad-spectrum penicillin all acute symptoms disappeared but he lost 8 kg within 3 months and his general state health gradually deteriorated. After 3 months he suddenly developed leg oedema, dyspnoea and bouts of fever up to 38.8 degrees C. A loud cardiac murmur was now heard. Echocardiography demonstrated vegetations on the regurgitant aortic valve. Endocarditis being suspected he was at first treated with penicillin G (15 mega IU/d) and gentamycin (160 mg/d). The fever regressed, but after 8 days the blood culture grew Campylobacter fetus subspecies fetus. Antibiotic treatment was switched to imipenem, twice daily 500 mg, in accordance with sensitivity test results. Further blood cultures were sterile. Despite this the cardiac status deteriorated, the aortic regurgitation reaching grade IV. The valve was replaced with a bioprosthesis and the patient quickly improved postoperatively. Antibiotic treatment was stopped and the cardiovascular status became normal. The patient has now been free of symptoms and recurrence for 7 months.
Sitter
T
T
Medizinische Klinik, Universität München.
Bauer
M F
MF
Held
E
E
D000208:Acute Disease; D000437:Alcoholism / Q000150:complications; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001705:Bioprosthesis; D002169:Campylobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002168:Campylobacter fetus; D016123:Campylobacter jejuni; D003131:Combined Modality Therapy; D003967:Diarrhea / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged
D000900:Anti-Bacterial Agents
Akute Aorteninsuffizienz nach Endokarditis durch Infektion mit Campylobacter fetus subspecies fetus.