Prosthetic valve endocarditis due to small-colony staphylococcal variants.
Although Staphylococcus epidermidis is a major cause of prosthetic valve endocarditis, little is known about the pathogenesis of this disease. In one case described herein, small-colony variant forms of S. epidermidis were isolated from clinical specimens obtained from a patient with prosthetic valve endocarditis. Data from the rat model of experimental endocarditis provide further evidence that small-colony variants may be operative in the production of prosthetic valve infection. Moreover, a review of the literature indicates that small-colony variants could account for the subtle clinical course after prolonged dormant infection that characterizes S. epidermidis prosthetic valve endocarditis. It is therefore hypothesized that small-colony variants of S. epidermidis may play a role in the pathogenesis of prosthetic valve endocarditis.
Baddour
L M
LM
Department of Medicine, University of Tennessee, Memphis 38163.
Christensen
G D
GD
D000818:Animals; D004195:Disease Models, Animal; D004697:Endocarditis, Bacterial / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051381:Rats; D013203:Staphylococcal Infections / Q000209:etiology*; D013212:Staphylococcus epidermidis