title: Tricuspid valve endocarditis due to a moderately susceptible Streptococcus constellatus: persistent bacteremia and fatal outcome despite penicillin plus gentamicin therapy.
abstract: An intravenous drug-user developed tricuspid valve endocarditis caused by a moderately susceptible strain of Streptococcus constellatus. Bacteremia and fever persisted despite penicillin and gentamicin therapy. Eventually, he developed massive hemoptysis and expired. We believe that the propensity of this group of organisms for suppurative complications and the suboptimal antibiotic susceptibility may have contributed to the failure of medical therapy and the fatal outcome. Similar cases may benefit from a higher dose of penicillin or early surgical intervention.
authors.affiliation: Department of Medicine, St John Hospital and Medical Center, Detroit, Michigan, USA.
authors.forename: J
authors.initials: J
authors.lastname: Baran
authors.forename: W M
authors.initials: WM
authors.lastname: Abdo
authors.forename: K W
authors.initials: KW
authors.lastname: Merritt
authors.forename: R
authors.initials: R
authors.lastname: Khatib
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D017809:Fatal Outcome; D005839:Gentamicins / Q000494:pharmacology / Q000627:therapeutic use*; D006349:Heart Valve Diseases / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology / Q000627:therapeutic use*; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013291:Streptococcus / Q000187:drug effects* / Q000302:isolation & purification; D014261:Tricuspid Valve
chemical_list: D005839:Gentamicins; D010406:Penicillins