title: Neisseria sicca endocarditis requiring mitral valve replacement in a previously healthy adolescent.
abstract: Infective endocarditis due to Neisseria sicca, a normal inhabitant of the upper respiratory tract, is rarely reported but associated with embolic phenomena and large vegetations often requiring surgical intervention. We report a previously healthy 12-year-old girl who presented with prolonged fever and altered mental status. The patient developed rapidly progressive respiratory insufficiency and cardiovascular instability, and echocardiography demonstrated a large vegetation on the mitral valve. She developed worsening mitral regurgitation with resultant pulmonary hemorrhage and underwent mitral valve replacement. Her blood culture was positive for N. sicca. This infection should be considered in patients with prolonged high fever and multiorgan dysfunction. Despite a typically severe course, reported mortality is low.
authors: Division of Emergency Medicine, The Children's Hospital of Philadelphia, PA, USA. aronsonp@email.chop.edu
authors: Paul L
authors: PL
authors: Aronson
authors: Kyle A
authors: KA
authors: Nelson
authors: Laura
authors: L
authors: Mercer-Rosa
authors: Aaron
authors: A
authors: Donoghue
mesh_terms: D002648:Child; D018450:Disease Progression; D004697:Endocarditis, Bacterial / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D042808:Neisseria sicca; D016870:Neisseriaceae Infections / Q000150:complications / Q000601:surgery*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000382:microbiology / Q000628:therapy; D014463:Ultrasonography