[Enterococcal endocarditis--a case report].
BACKGROUND
Bacteria from genus Enterococcus may cause infections mostly in those who are immunocompromised and those who underwent endoscopic or surgical procedures. Endocarditis is caused by enterococci in 5-10% of cases. Its clinical presentation does not differ from endocarditis of other bacterial origin. Previous susceptibility testing is needed for appropriate choice of antibiotics against enterococci. The treatment recommendations for enterococcal endocarditis were given by American Heart Association recently.


METHODS
A case ofenterococcal endocarditis in a young female person hospitalised at Clinic for infectious diseases was reviewed. The disease was diagnosed during an extensive diagnostic procedure. Multiply repeated echocardiographic examination helped to find out bacterial vegetations on the mitral valve. Enterococcus species was isolated from several blood cultures. Despite powerful antibiotic treatment, the additional valvular replacement had to be done.


CONCLUSIONS
A case of enerococcal endocarditis in a young female person was reviewed. The right diagnosis was based on a thorough clinical examination in cooperation with cardiologists using repeated transthoracic and transesophageal echocardiography. Echocardiography, even if it is transesophageal, has limited sensitivity and specificity, so it is sometimes necessary to be repeated for several times in diagnosing endocarditis. The source of endocarditis was not identified. The combined antimicrobial and surgical treatment led to the complete recovery of patient.


CONCLUSIONS
Enterococcal endocarditis rarely occurrs in young females. Infective disease specialists sometimes face enterococcal endocarditis in their practice, mostly when they have to cope with fever of unknown origin. An appropriate approach to such conditions includes careful search for heart valve changes by repeated echocardiographic finding, if necessary.
Cvjetković
Dejan
D
Klinika za infektivne bolesti, Klinicki centar Vojvodine, Novi Sad. ivacvj@neobee.net
Aleksić-Dordević
Mirjana
M
Jovanović
Jovana
J
Hrnjaković-Cvjetković
Ivana
I
Stefan-Mikić
Sandra
S
Sević
Sinisa
S
D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis*; D006801:Humans; D055815:Young Adult