title: Infective endocarditis and osteomyelitis caused by Cellulomonas: a case report and review of the literature.
abstract: Cellulomonas spp. are often believed to be of low virulence and have never been reported as a pathogen causing human disease before. We report the first case of endocarditis caused by Cellulomonas and complicated with osteomyelitis of the lumbar spine in a 78-year-old woman. General weakness and aggravated lower back pain followed by sudden-onset of fever and chills were the major presentation. The diagnosis of infective endocarditis in this case was definitely using the Duke criteria. The magnetic resonance imaging of the lumbar spine revealed infective spondylodisciitis at an early stage. After a full course of antibiotics treatment, the patient's fever subsided but her lower back pain persisted. A slow clinical response to appropriate antimicrobial agents was characteristic of Gram-positive bacillary endocarditis.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Tian-Sheng Memorial Hospital, Donggang, Pingtung Country 92842, Taiwan, ROC. pclai.tw@msa.hinet.net
authors.forename: Ping-Chang
authors.initials: PC
authors.lastname: Lai
authors.forename: Yao-Shen
authors.initials: YS
authors.lastname: Chen
authors.forename: Susan Shin-Jung
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D040143:Cellulomonas / Q000302:isolation & purification*; D015299:Discitis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D010019:Osteomyelitis / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D011860:Radiography, Abdominal
chemical_list: D000900:Anti-Bacterial Agents