title: Kytococcus schroeteri: a probably underdiagnosed pathogen involved in prosthetic valve endocarditis.
abstract: Kytoccoccus schroeteri is an emerging pathogen found mainly in association with prosthetic valve endocarditis. A striking aspect of this species is its resistance to penicillins, including isoxazolylpenicillins, making glycopeptide administration and valve replacement the treatment of choice. We present the case of a 38-year-old female diabetic patient with fever up to 39.1 degrees C for two months. Infection of her prosthetic aortic valve was suspected clinically. Repeated blood cultures revealed growth of K. schroeteri. Transesophageal echocardiography demonstrated a vegetation on the prosthetic aortic valve. Antibiotic treatment with vancomycin, rifampin and gentamicin was started and this regimen led to complete resolution of symptoms and disappearance of the vegetation. It is of particular interest that the patient recovered without further surgical procedures. Since the first description of K. schroeteri in 2002, four cases of endocarditis have been published, suggesting antecedent and continuing underdiagnosis.
authors.affiliation: Department of Medical Microbiology, Hygiene and Virology, University of Rostock, Rostock, Germany. christian.aepinus@med.uni-rostock.de
authors.forename: Christian
authors.initials: C
authors.lastname: Aepinus
authors.forename: Esther
authors.initials: E
authors.lastname: Adolph
authors.forename: Christof
authors.initials: C
authors.lastname: von Eiff
authors.forename: Andreas
authors.initials: A
authors.lastname: Podbielski
authors.forename: Michael
authors.initials: M
authors.lastname: Petzsch
mesh_terms: D000192:Actinomycetales / Q000472:pathogenicity*; D000193:Actinomycetales Infections / Q000175:diagnosis / Q000382:microbiology*; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D004269:DNA, Bacterial / Q000235:genetics; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006350:Heart Valve Prosthesis / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000008:administration & dosage; D016133:Polymerase Chain Reaction; D012293:Rifampin / Q000008:administration & dosage; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D004269:DNA, Bacterial; D005839:Gentamicins; D014640:Vancomycin; D015242:Ofloxacin; D012293:Rifampin