title: Case report: infective endocarditis caused by Brevundimonas vesicularis.
abstract: BACKGROUND
  There are few reports in the literature of invasive infection caused by Brevundimonas vesicularis in patients without immunosuppression or other predisposing factors. The choice of antimicrobial therapy for bacteremia caused by the pathogen requires more case experience to be determined.
  
  
  METHODS
  The case of a 40-year-old previously healthy man with subacute endocarditis proposed to be contributed from an occult dental abscess is described. The infection was found to be caused by B. vesicularis on blood culture results. The patient recovered without sequelae after treatment with ceftriaxone followed by subsequent ciprofloxacin therapy owing to an allergic reaction to ceftriaxone and treatment failure with ampicillin/sulbactam.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of B. vesicularis as a cause of infective endocarditis. According to an overview of the literature and our experience, we suggest that third-generation cephalosporins, piperacillin/tazobactam, and ciprofloxacin are effective in treating invasive B. vesicularis infections, while the efficacy of ampicillin-sulbactam needs further evaluation.
authors.affiliation: Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan. 940424@ms.kmuh.org.tw
authors.forename: Mei-Li
authors.initials: ML
authors.lastname: Yang
authors.forename: Yen-Hsu
authors.initials: YH
authors.lastname: Chen
authors.forename: Tun-Chieh
authors.initials: TC
authors.lastname: Chen
authors.forename: Wei-Ru
authors.initials: WR
authors.lastname: Lin
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lu
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011549:Pseudomonas / Q000145:classification* / Q000302:isolation & purification; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents