title: [A case of isolated pulmonary valve infective endocarditis in a 78-year-old woman].
abstract: A 78-year-old woman was admitted to our hospital with lumbago. Her activities of daily living had previously been completely independent. However, she developed temporary chills in January 2009, that improved without treatment, but recurred on February 7, 2009 in association with left lumbago and loss of appetite. She was then referred to our hospital with a disturbance of consciousness and high fever on February 14. A blood test performed on admission revealed an elevated inflammatory response, coagulation disorder and low platelet count, and abdominal computed tomography demonstrated findings suggestive of pyogenic spondylitis. The patient was therefore admitted and treated with antibiotic therapy; however, she died on day 8 due to complications of disseminated intravascular coagulation. An autopsy showed isolated pulmonary valve endocarditis. The patient's history was later found to include regular dental treatment, and the same Streptococcus group G was detected in cultures of the sputum, blood and vegetation. It is important to interview patients regarding their history of dental treatment, particularly elderly individuals with fever of unknown origin.
authors.affiliation: Department of Geriatric Medicine, Kyorin Medical University.
authors.forename: Masashi
authors.initials: M
authors.lastname: Osada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Inoue
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Moriya
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Wachi
authors.forename: Noriko
authors.initials: N
authors.lastname: Sudo
authors.forename: Koichi
authors.initials: K
authors.lastname: Kozaki
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001344:Autopsy; D003784:Dental Pulp Calcification / Q000628:therapy*; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D011664:Pulmonary Valve / Q000473:pathology*; D013290:Streptococcal Infections / Q000188:drug therapy*; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents