title: Infective endocarditis following body piercing: Presentation of one case due to Gemella morbillorum and review of the literature.
abstract: BACKGROUND
  In the last decade, body piercing has gained strongly in popularity. There are a few reports in the literature regarding infective endocarditis after body piercing.
  
  
  METHODS
  The case of an 18-year-old girl with heart failure and a six-month history of recurring fever is presented. Clinical and laboratory evaluation led to the diagnose of infective endocarditis due to Gemella morbillorum. Oral piercing was recognized to be the cause of bacteremia. Fourteen cases of infective endocarditis related to body piercing were found in the literature and the clinical, etiologic, pathogenic, and preventive aspects of this topic are presented.
  
  
  CONCLUSIONS
  Infective endocarditis may be a complication of body piercing and has been observed in patients with heart lesions as well as in previous healthy people. Infective endocarditis can follow body piercing involving either mucous membranes or the skin. This patient is the first case of Gemella morbillorum endocarditis after body piercing reported in the literature. Careful observation for infection at the site of piercing and its treatment as well as professional training for operators seem to be the most effective way to minimize the risk of infective endocarditis after body piercing.
authors.affiliation: Department of Pediatrics, University of Parma, Parma, Italy. nicola.carano@unipr.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Carano
authors.forename: Aldo
authors.initials: A
authors.lastname: Agnetti
authors.forename: Valentina
authors.initials: V
authors.lastname: Allegri
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tchana
authors.forename: Antonio
authors.initials: A
authors.lastname: Saracino
authors.forename: Marcello
authors.initials: M
authors.lastname: Sommi
authors.forename: Ilaria
authors.initials: I
authors.lastname: Bo
authors.forename: Umberto
authors.initials: U
authors.lastname: Squarcia
mesh_terms: D000293:Adolescent; D046288:Body Piercing / Q000009:adverse effects*; D004697:Endocarditis, Bacterial / Q000150:complications / Q000209:etiology* / Q000382:microbiology; D005260:Female; D058834:Gemella; D016908:Gram-Positive Bacterial Infections / Q000209:etiology*; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000209:etiology