Cardiobacterium hominis endocarditis presenting as acute embolic stroke: a case report and review of the literature.
We report on a case of endocarditis attributable to Cardiobacterium hominis in a 31-year-old man who presented with acute-onset, left-sided hemiparesthesia. Magnetic resonance imaging of the brain showed acute infarctions in 2 areas of the right cerebral cortex, and a transesophageal echocardiogram revealed vegetation in a previously unrecognized bicuspid aortic valve. The patient completed a 6-week course of ceftriaxone and aspirin, with resolution of the vegetation and neurological complications. Our literature review of C. hominis endocarditis suggests that aortic-valve involvement is associated with high stroke and valve-surgery rates. Favorable outcomes and treatment success are evident with either penicillin or ceftriaxone, in combination with (if indicated) valve surgery in patients with neurological complications.
Chentanez
Teera
T
Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Khawcharoenporn
Thana
T
Chokrungvaranon
Nalurporn
N
Joyner
James
J
D000125:Achilles Tendon; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D044066:Cardiobacterium; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis*; D003424:Crohn Disease / Q000188:drug therapy; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis*; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008297:Male; D019804:Mesalamine / Q000009:adverse effects / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000175:diagnosis*; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D052256:Tendinopathy / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine; D011241:Prednisone