Case report of Staphylococcus lugdunensis native valve endocarditis and review of the literature.
BACKGROUND
Coagulase-negative staphylococci, commonly Staphylococcus epidermidis, cause 5% of native valve endocarditis. We describe a case due to Staphylococcus lugdunensis, a coagulase-negative staphylococcus identified in 1988, as a first report in Southeast Asia. It was previously misidentified as S. aureus because it is sometimes slide coagulase positive, but always tube coagulase negative, resulting in its delayed recognition as a pathogen. We also reviewed 36 other cases reported in the English literature from 1988 to 1999.


METHODS
Our patient was admitted 3 times over 4 months for unresolved weight loss and fever before the coagulase-negative staphylococcus bacteraemia was eventually considered significant.


RESULTS
He was treated with 4 weeks of high-dose intravenous penicillin and 2 weeks of gentamicin and did not require urgent valve replacement.


CONCLUSIONS
A positive blood culture of coagulase-negative staphylococcus is not always a contaminant. S. lugdunensis can cause aggressive native valve endocarditis resulting in high mortality, especially without surgical intervention.
Teong
H H
HH
Department of Internal Medicine, Singapore General Hospital, 1 Hospital Drive, Singapore 169608. zhfteong@mbox3.singnet.com.sg
Leo
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Wong
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D000328:Adult; D016470:Bacteremia / Q000382:microbiology; D003030:Coagulase; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D012846:Singapore; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013210:Staphylococcus / Q000302:isolation & purification
D003030:Coagulase