Gemella morbillorum endocarditis in hypertrophic cardiomyopathy: a rare organism causing a large vegetation and abscess in an uncommon setting.
Mitral valve endocarditis complicating hypertrophic cardiomyopathy is rare especially in the absence of significant mitral regurgitation. The occurrence of large vegetation and an abscess formation is even rarer. Endocarditis occurs predominantly on the left ventricular aspect of the anterior mitral leaflet. We report a case of a 34-year-old woman with asymptomatic obstructive hypertrophic cardiomyopathy who developed mitral valve endocarditis with large vegetation and subsequently an abscess caused by a rare organism Gemella morbillorum, following dental extraction. The patient underwent antibacterial therapy followed by successful mitral valve replacement for severe mitral regurgitation and her postoperative course has been asymptomatic so far. This case is unique in describing endocarditis by a rare organism as a cause of large vegetation and an abscess on an unusual site on the mitral valve leaflet without predisposition of haemodynamically significant mitral regurgitation and illustrates the potential lifesaving role of timely intervention.
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
Vikram B
VB
Kolhari
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
V Vinoth
VV
Kumar
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
Navin
N
Agrawal
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
Sadashivappa Surhonne
SS
Prakash
D000038:Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D015150:Echocardiography, Doppler; D004696:Endocarditis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D058834:Gemella / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents