title: Infective endocarditis caused by multidrug-resistant Streptococcus mitis in a combined immunocompromised patient: an autopsy case report.
abstract: An autopsy case of infective endocarditis caused by multidrug-resistant Streptococcus mitis was described in a patient with a combination of factors that compromised immune status, including autoimmune hemolytic anemia, post-splenectomy state, prolonged steroid treatment, and IgA deficiency. The isolated S. mitis strain from blood culture was broadly resistant to penicillin, cephalosporins, carbapenem, macrolides, and fluoroquinolone. Recurrent episodes of bacterial infections and therapeutic use of several antibiotics may underlie the development of multidrug resistance for S. mitis. Because clinically isolated S. mitis strains from chronically immunocompromised patients have become resistant to a wide spectrum of antibiotics, appropriate antibiotic regimens should be selected when treating invasive S. mitis infections in these compromised patients.
authors.affiliation: Department of Pathology and Laboratory Medicine, Kariya Toyota General Hospital, 5-15 Sumiyoshi, Kariya, Aichi, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Matsui
authors.forename: Makoto
authors.initials: M
authors.lastname: Ito
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kuramae
authors.forename: Tomomi
authors.initials: T
authors.lastname: Inukai
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Sakai
authors.forename: Masaru
authors.initials: M
authors.lastname: Okugawa
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001344:Autopsy; D024901:Drug Resistance, Multiple, Bacterial; D004697:Endocarditis, Bacterial / Q000276:immunology* / Q000382:microbiology*; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008826:Microbial Sensitivity Tests; D011655:Pulmonary Embolism / Q000276:immunology / Q000382:microbiology; D013290:Streptococcal Infections / Q000276:immunology* / Q000382:microbiology*; D034361:Streptococcus mitis / Q000187:drug effects / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents