title: Bacteria endocarditis consolidation with vertebra bone tuberculosis: a case report.
abstract: The clinical features of bacteria endocarditis became atypical when consolidated with other conditions such as tuberculosis (TB). Especially, the symptoms of bacteria endocarditis (BE) which were hidden behind the TB fever often lead to misdiagnosis and missed diagnosis.
  
  
  
  A 56-year-old male with thoracic vertebra bone TB history presented with low-grade fever, shortness of breath and cardiac souffle. After conventional antibiotic therapy and strengthen anti-tuberculosis treatment condition did not be improved. Further inspection, there were bacteria endocarditis with the vegetation across the mitral valve. But the other valves were not involved. He was treated with intravenous penicillin for 4 weeks in all including during surgery, and following with oral antibiotic for another 2 weeks. The patient improved clinically eventually.
  
  
  
  It is the first reported case of isolated thoracic vertebra tuberculosis with valve endocarditis caused by streptococcus viridans and was successfully managed by combination therapy of internal medicine and surgery. It was suggested in tuberculosis patients, the possibility of bacterial endocarditis should be considered when came into fever and unexplained cardiac soufflé (in tuberculosis patients).
authors.affiliation: Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of ultrasound diagnosis, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, People's Republic of China.
authors.forename: Yongsheng
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China.
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Geriatrics, Weinan Central Hospital, Weinan, 714000, Shaanxi Province, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China.
authors.forename: Rong
authors.initials: R
authors.lastname: Xu
authors.affiliation: Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China. geweidr@fmmu.edu.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Ge
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D013290:Streptococcal Infections / Q000188:drug therapy*; D014394:Tuberculosis, Osteoarticular / Q000188:drug therapy*; D034363:Viridans Streptococci / Q000472:pathogenicity
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D010406:Penicillins
keywords: Bacteria endocarditis (BE); Thoracic vertebra tuberculosis; Viridans streptococcus