title: A rare native mitral valve endocarditis successfully treated after surgical correction.
abstract: Mycobacterium abscessus and Kocuria species are rare causes of infections in humans. Endocarditis by these agents has been reported in only 11 cases. M. abscessus is a particularly resistant organism and treatment requires the association of antibiotics for a prolonged period of time. We report a case of native mitral valve bacterial endocarditis due to M. abscessus and Kocuria species in a 48-year-old man with a history of intravenous drug use. The case was complicated by a perforation of the posterior mitral valve leaflet, leading to surgical mitral valve replacement. Cultures from the blood and mitral valve disclosed M. abscessus and Kocuria species. The patient was treated for 6 months with clarithromycin, imipenem and amikacin, with resolution of symptoms. Repeated blood cultures were negative. Acid-fast staining should be done in subacute endocarditis in order to identify rapidly growing mycobacteria.
authors.affiliation: Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Garcia
authors.affiliation: Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA.
authors.forename: Rhanderson
authors.initials: R
authors.lastname: Nascimento
authors.affiliation: Department of Cardiology, Jackson Memorial Hospital, Miami, Florida, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Soto
authors.affiliation: Department of Cardiology, Jackson Memorial Hospital, Miami, Florida, USA.
authors.forename: Cesar E
authors.initials: CE
authors.lastname: Mendoza
mesh_terms: D000193:Actinomycetales Infections / Q000150:complications*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008297:Male; D008835:Micrococcaceae; D008875:Middle Aged; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications*; D035583:Rare Diseases; D015819:Substance Abuse, Intravenous / Q000150:complications*