title: Abiotrophia defectiva Endocarditis Complicated by Ventricular Tachycardia.
abstract: A 78-year-old man was admitted to the authors' hospital with a short history of shortness of breath and pyrexia. He had long-standing moderate mitral regurgitation and stable coronary artery disease. Blood cultures grew Abiotrophia defectiva coccobaccili. Transesophageal echocardiography confirmed the diagnosis of mitral valve endocarditis that necessitated treatment with intravenous benzylpenicillin and gentamicin for six weeks. At nine days after admission the patient developed several episodes of self-limiting monomorphic ventricular tachycardia, without ischemic cardiac pain, associated with hemodynamic compromise requiring treatment with intravenous amiodarone and inotropic support in the Intensive Care Unit. The patient made an uneventful recovery. This case report demonstrates that patients with A. defective endocarditis may be associated with life-threatening ventricular tachycardia, and more so if they have underlying coronary artery disease. Hence, these patients are better managed in the Coronary Care Unit with continuous electrocardiogram monitoring, especially in the early stages of the antibiotic treatment.
authors.affiliation: Frimley Health NHS Foundation Trust.
authors.forename: Kyriacos
authors.initials: K
authors.lastname: Mouyis
authors.affiliation: Frimley Health NHS Foundation Trust.
authors.forename: Sophia
authors.initials: S
authors.lastname: Metaxa
authors.affiliation: Frimley Health NHS Foundation Trust.|International Centre for Circulatory Health, NHLI, Imperial College, London, United Kingdom.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Missouris
mesh_terms: D058835:Abiotrophia / Q000302:isolation & purification*; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D017548:Echocardiography, Transesophageal / Q000379:methods; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005839:Gentamicins / Q000008:administration & dosage*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D010400:Penicillin G / Q000008:administration & dosage*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000638:Amiodarone; D010400:Penicillin G