title: Infective endocarditis caused by Neisseria elongata on a native tricuspid valve and confirmed by DNA sequencing.
abstract: Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies.
authors.affiliation: Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea.
authors.forename: Yeon Pyo
authors.initials: YP
authors.lastname: Yoo
authors.affiliation: Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea.
authors.forename: Ki-Woon
authors.initials: KW
authors.lastname: Kang
authors.affiliation: Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea.
authors.forename: Hyeon Soo
authors.initials: HS
authors.lastname: Yoon
authors.affiliation: Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea.
authors.forename: Seungmin
authors.initials: S
authors.lastname: Yoo
authors.affiliation: Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea.
authors.forename: Myung-Shin
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002437:Cefazolin / Q000008:administration & dosage*; D015150:Echocardiography, Doppler / Q000379:methods; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D042805:Neisseria elongata / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000382:microbiology / Q000473:pathology; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002437:Cefazolin
keywords: Bacterial typing techniques; DNA, bacterial/analysis; Neisseria elongata/analysis/classification/isolation & purification/microbiology/pathogenicity; endocarditis, bacterial/complications/drug therapy/microbiology; gram-negative bacterial infections/diagnosis/drug therapy; heart valve diseases/diagnosis/drug therapy; heart ventricles/abnormalities; species specificity; treatment outcome