title: Infective endocarditis due to Abiotrophia defectiva: a report of two cases.
abstract: OBJECTIVE
  Endocarditis due to Abiotrophia sp. is rare and often associated with negative blood cultures. The rates of treatment failure, infection relapse and mortality are higher than in endocarditis caused by other viridans streptococci.
  
  
  METHODS
  A retrospective review of A. defectiva endocarditis in a patient with prosthetic aortic valve and in a patient with Marfan syndrome was performed.
  
  
  RESULTS
  A. defectiva, susceptible to penicillin (MIC 0.064 mg/l and 0.016 mg/l, respectively) was isolated from blood cultures of both patients. Treatment with penicillin and gentamicin was started in both patients. Since the first patient developed a macular rash and leukopenia, penicillin was substituted with ceftriaxone. Both patients responded well to antibiotic treatment, did not need prosthetic valve insertion or reinsertion, and were without any sequelae at one year follow up.
  
  
  CONCLUSIONS
  Standard treatment of bacterial endocarditis with penicillin and gentamicin was effective in both patients. In contrast to previous reports, the present patients had a favorable outcome on completion of treatment and at one-year follow up.
authors.affiliation: General Hospital Murska Sobota, Murska Sobota, Slovenia. mitja.lainscak@guest.arnes.si
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
authors.forename: Tatjana
authors.initials: T
authors.lastname: Lejko-Zupanc
authors.forename: Iztok
authors.initials: I
authors.lastname: Strumbelj
authors.forename: Ivan
authors.initials: I
authors.lastname: Gasparac
authors.forename: Manica
authors.initials: M
authors.lastname: Mueller-Premru
authors.forename: Mateja
authors.initials: M
authors.lastname: Pirs
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D002443:Ceftriaxone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D005839:Gentamicins / Q000627:therapeutic use; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000175:diagnosis; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D010406:Penicillins; D002443:Ceftriaxone