title: Early-onset Streptomyces endocarditis in a prosthetic aortic valve.
abstract: A 66-year-old Australian man underwent elective replacement of a severely stenotic aortic valve with a 22-mm Medtronic-Hall valve. Six weeks later, he was readmitted with worsening dyspnea, fever, and mild anemia. Investigations confirmed pulmonary edema and moderate periprosthetic aortic regurgitation. The pulmonary edema was managed conservatively, and a second 22-mm Medtronic-Hall valve was implanted. Infective endocarditis was suspected in the aortic annulus below the orifice of the right coronary artery. A bacteriological study revealed a rare bacteria of Streptomyces species. The patient received intensive antibiotic therapy over a 6-week period of hospitalization, and the aortic regurgitation disappeared one week postoperatively.
authors.affiliation: 1 Cardiac Surgery, Farok Medical City, Sulaimaniyah, Iraq.|2 School of Surgery, University of Western Australia, Australia.
authors.forename: Jaffar S
authors.initials: JS
authors.lastname: Shehatha
authors.affiliation: 3 Sulaimaniyah Teaching Hospital, School of Medicine, University of Sulaimaniyah, Sulaimaniyah, Iraq.
authors.forename: Abdulsalam Y
authors.initials: AY
authors.lastname: Taha
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017558:Elective Surgical Procedures; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008297:Male; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D012086:Reoperation; D012720:Severity of Illness Index; D013302:Streptomyces / Q000302:isolation & purification*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Aortic valve; Bacteremia; Endocarditis; Heart valve prosthesis; Prosthesis-related infections; Streptomyces; bacterial