title: Pacemaker-induced Staphylococcus aureus mitral valve acute bacterial endocarditis complicated by persistent bacteremia from a coronary stent: Cure with prolonged/high-dose daptomycin without toxicity.
abstract: Continuous high-grade Staphylococcus aureus bacteremia suggests acute bacterial endocarditis (ABE), a protected focus, ie, an abscess, or a device-related infection. Daptomycin was curative of S. aureus ABE and coronary stent-related bacteremia. Prolonged high-dose daptomycin therapy (12 mg/kg per day for 41 days) is not associated with any toxicity. Persistent S. aureus bacteremia in ABE should suggest myocardial or perivalvular abscess. If intracardiac abscess can be ruled out and there is no extracardiac source of the S. aureus bacteremia, then a device-related infection should be considered.
authors.affiliation: Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
authors.forename: Burke A
authors.initials: BA
authors.lastname: Cunha
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Eisenstein
authors.forename: Naveed S
authors.initials: NS
authors.lastname: Hamid
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003327:Coronary Disease / Q000150:complications / Q000628:therapy; D017576:Daptomycin / Q000494:pharmacology / Q000627:therapeutic use; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008943:Mitral Valve; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015607:Stents / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin