title: Gonococcal endocarditis in a 47-year-old Japanese man.
abstract: A 47-year-old sexually active Japanese man was admitted with a persistent fever and weight loss. A physical examination revealed a cardiac murmur. A transthoracic echocardiogram was nondiagnostic, although blood cultures grew Neisseria gonorrhoeae. Gonococcal endocarditis was diagnosed based on the modified Duke criteria. The administration of antimicrobial therapy resulted in an adequate initial resolution; however, two months after completing the therapy, the patient developed cardiac failure. Severe aortic regurgitation was identified, and the patient underwent emergent aortic valve replacement. Despite the rarity of gonococcal endocarditis, this disease should nevertheless be considered in patients presenting with a fever, cardiac murmur and a consistent sexual history.
authors.affiliation: Department of Respiratory Medicine, Chubu Rosai Hospital, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Takaya
authors.initials: T
authors.lastname: Ozeki
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsuo
authors.forename: Joel
authors.initials: J
authors.lastname: Branch
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Fujita
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Marui
mesh_terms: D003937:Diagnosis, Differential; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*