title: Endocarditis by Kocuria rosea in an immunocompetent child.
abstract: Kocuria rosea belongs to genus Kocuria (Micrococcaceae family, suborder Micrococcineae, order Actinomycetales) that includes about 11 species of bacteria. Usually, Kocuria sp are commensal organisms that colonize oropharynx, skin and mucous membrane; Kocuria sp infections have been described in the last decade commonly affecting immunocompromised patients, using intravenous catheter or peritoneal dialysis. These patients had mainly bacteremia/recurrent sepsis. We hereby describe the case of a 10-year-old girl, immunocompetent, who had endocarditis/sepsis by K. rosea which was identified in five different blood cultures by Vitek 2 ID-GPC card (BioMérieux, France). Negative HIV serology, blood count within normal range of leukocytes/neutrophils and lymphocytes, normal fractions of the complement, normal level of immunoglobulins for the age; lymphocyte immunophenotyping was also within the expected values. Thymus image was normal at chest MRI. No catheters were required. Identification of K. rosea was essential to this case, allowing the differentiation of coagulase-negative staphylococci and use of an effective antibiotic treatment. Careful laboratory analysis of Gram-positive blood-born infections may reveal more cases of Kocuria sp infections in immunocompetent patients, which may collaborate for a better understanding, prevention and early treatment of these infections in pediatrics.
authors.affiliation: Pontificia Universidade Católica de Campinas/Puccamp, Campinas, SP, Brazil.
authors.forename: Jorge Salomão
authors.initials: JS
authors.lastname: Moreira
authors.affiliation: Pediatric Immunology, Center for Investigation in Pediatrics (CIPED), Pediatrics Department, Faculty of Medical Sciences, State University of Campinas/Unicamp, Campinas, SP, Brazil. Electronic address: aglriccetto@gmail.com.
authors.forename: Adriana Gut Lopes
authors.initials: AG
authors.lastname: Riccetto
authors.affiliation: Pediatric Immunology, Center for Investigation in Pediatrics (CIPED), Pediatrics Department, Faculty of Medical Sciences, State University of Campinas/Unicamp, Campinas, SP, Brazil.
authors.forename: Marcos Tadeu Nolasco da
authors.initials: MT
authors.lastname: Silva
authors.affiliation: Pediatric Immunology, Center for Investigation in Pediatrics (CIPED), Pediatrics Department, Faculty of Medical Sciences, State University of Campinas/Unicamp, Campinas, SP, Brazil.
authors.forename: Maria Marluce dos Santos
authors.initials: MM
authors.lastname: Vilela
mesh_terms: D002648:Child; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008835:Micrococcaceae / Q000145:classification*
keywords: Children; Immune system; Infectious endocarditis; Kocuria rosea