[Infectious endocarditis following artificial insemination. A clinical case report and review of the literature].
We describe a case of infective endocarditis in a 33 year old patient, with mitral valve prolapse (MVP), who underwent nine attempts of artificial insemination with semen by donor. Several blood cultures demonstrated the presence of Enterococcus faecalis; the same agent was identified in some vaginal cultures. Despite antibiotic therapy, infective endocarditis was complicated by severe mitral regurgitation, followed by the rupture of a chorda tendinea. The patient underwent cardiac surgery: valvuloplasty of posterior mitral cusp, chordae tendineae in Goretex and anulus reinforcement with autologous pericardium. MVP is the most common heart disease associated with infective endocarditis in non-drug addict patients (32-54%). The review of the literature did not show any other case of infective endocarditis after artificial insemination procedures. Because of the large spread of these procedures, we think antibiotic prophylaxis of infective endocarditis should be considered in patients with MVP.
Caprino
E
E
Divisione di Cardiologia, Ospedale Civile degli Infermi, Vigevano, Pavia.
Cortesi
G
G
Villani
R
R
Caccia
M E
ME
Lauria
F
F
Nava
S
S
D000328:Adult; D002815:Chordae Tendineae; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D013293:Enterococcus faecalis; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D006341:Heart Rupture / Q000209:etiology; D006801:Humans; D007316:Insemination, Artificial, Heterologous / Q000009:adverse effects*; D008944:Mitral Valve Insufficiency / Q000209:etiology; D008945:Mitral Valve Prolapse / Q000150:complications; D013997:Time Factors; D014262:Tricuspid Valve Insufficiency / Q000209:etiology
Endocardite infettiva seguita ad inseminazione artificiale. Descrizione di un caso clinico e revisione della letteratura.