title: [Active infective endocarditis remaining latent for six weeks after discontinuation of antibiotic therapy: a case report].
abstract: A 75-year-old man was treated for 4 weeks with penicillin administration for infective endocarditis in the mitral valve caused by Enterococcus faecalis. The infection recurred, so he received penicillin administration for a further 6 weeks. He remained afebrile and all laboratory examinations were within normal limits for 6 weeks after the antibiotic treatment was discontinued, but the vegetation remained large and highly mobile. Since the onset, possible embolic episodes had occurred three times. He underwent mitral valve repair with annuloplasty. Although the infection appeared to have healed by antibiotic therapy, resected tissue was strongly positive for Enterococcus faecalis. This case suggests that surgery should be aggressively considered if the vegetation does not shrink markedly.
authors.affiliation: Department of Cardiovascular Surgery, Saitama Medical School. masuoka@saitama-med.ac.jp
authors.forename: Ayumu
authors.initials: A
authors.lastname: Masuoka
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Imanaka
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Sugie
authors.forename: Masanori
authors.initials: M
authors.lastname: Ogiwara
authors.forename: Motonobu
authors.initials: M
authors.lastname: Nishimura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kato
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Asano
authors.forename: Koetsu
authors.initials: K
authors.lastname: Kuboi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamada
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Nishimura
authors.forename: Shunei
authors.initials: S
authors.lastname: Kyo
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery; D010400:Penicillin G / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G