title: Staphylococcus lugdunensis Endocarditis in a 35-Year-Old Woman in Her 24th Week of Pregnancy.
abstract: Background. Infective endocarditis is associated with considerable morbidity and mortality. Guidelines addressing prophylaxis and management of infective endocarditis do not extensively deal with concomitant pregnancy, and case reports on infective endocarditis are scarce. This is the first published report of infective endocarditis by Staphylococcus lugdunensis in a pregnant woman. Case Presentation. We report a single case of a 35-year-old woman in her 24th week of pregnancy who was admitted to our intensive care unit with fever and suspected infectious endocarditis. Blood culture detected Staphylococcus lugdunensis. A vegetation and severe mitral regurgitation due to complete destruction of the valve confirmed the diagnosis. An interdisciplinary panel of cardiologists, maternal-fetal medicine specialists, cardiac and plastic surgeons, infectiologists, anesthesiologists, and neonatologists was formed to determine the best therapeutic strategy. Conclusions. Timing and indications for surgical intervention to prevent embolic complications in infective endocarditis remain controversial. This original case report illustrates how managing infective endocarditis by Staphylococcus lugdunensis particularly in the 24th week of pregnancy can represent a therapeutic challenge to a broad section of specialties across medicine. Critical cases like this require a thorough weighing of risks and benefits followed by swift action to protect the mother and her unborn child.
authors.affiliation: Department of Cardiology, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Mounir
authors.initials: M
authors.lastname: Khafaga
authors.affiliation: Department of Cardiology, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Karl-Patrik
authors.initials: KP
authors.lastname: Kresoja
authors.affiliation: Division of Neonatology, Department of Paediatrics, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Berndt
authors.initials: B
authors.lastname: Urlesberger
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Igor
authors.initials: I
authors.lastname: Knez
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Klaritsch
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria.
authors.forename: David Benjamin
authors.initials: DB
authors.lastname: Lumenta
authors.affiliation: Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Krause
authors.affiliation: Department of Cardiology, Medical University of Graz, 8036 Graz, Austria.
authors.forename: Dirk
authors.identifier: 0000-0001-9996-6128
authors.initials: D
authors.lastname: von Lewinski