Progressive Staphylococcus lugdunensis endocarditis despite antibiotic treatment.
A 68-year old man with fever chills and a diastolic murmur was diagnosed with aortic-valve endocarditis caused by coagulase-negative Staphylococcus lugdunensis. The clinical condition initially improved with antibiotic therapy. On day seven, transoesophageal echocardiography revealed large abscesses extending from the aortic root to the left ventricular wall. Emergency cardiac surgery was performed successfully and a stentless bioprosthetic valve was inserted. S. lugdunensis endocarditis is known for its aggressive clinical course with valve destruction, abscess formation and embolic complications despite appropriate antibiotics. Antibiotic treatment alone is associated with a high mortality rate which can be reduced by early valve replacement.
Division of Cardiology, Department of Medicine, University of Rostock, Rostock, Germany.
Michael
M
Petzsch
Werner
W
Leber
Bernd
B
Westphal
Sabine
S
Crusius
Emil C
EC
Reisinger
D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery; D002444:Cefuroxime / Q000627:therapeutic use*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010490:Pericardial Effusion / Q000175:diagnosis / Q000601:surgery; D012293:Rifampin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D013210:Staphylococcus / Q000187:drug effects; D014640:Vancomycin / Q000627:therapeutic use
D014640:Vancomycin; D002444:Cefuroxime; D012293:Rifampin