Gemella morbillorum endocarditis of pulmonary valve:a case report.
BACKGROUND
Pulmonary valve infective endocarditis is a rare finding for endocarditis. Infective endocarditis caused by Gemella morbillorum remains a scanty occurrence.


METHODS
This is a case reported of a 28-year-old Chinese male with endocarditis caused by pulmonary valve infection of Gemella morbillorum associated with congenital ventricular septal defect, atrial septal defect and double-chambered right ventricle. The patient presented with fever, shortness of breath, progressively worsening exertional fatigue, dyspnea and weight loss for 3 months. The diagnosis was made with transthoracic echocardiogram, blood cultures, and post-operative pathology. The patient developed congestive heart failure and was managed with aggressive antibiotic therapy followed by surgery. He underwent replacement of the pulmonary valve with an aortic bioprosthetic valve, repair of ventricular septal defect and atrial septal defect, reconstruction of the right ventricular outlflow tract, and excision of vegetations. His postoperative recovery was uneventful. No bacteria were isolated from the excised tissues. He was asymptomatic without recurrence at 3-month follow-up.


CONCLUSIONS
The rare pathogen such as Gemella morbillorum can be the cause of infective endocarditis and timely surgical repair is necessary if the infection is refractory or there is progression of congestive heart failure under antibiotic cover.
Department of Cardiovascular Surgery, The Second Hospital of Jilin University, 218 Ziqiang Street, Nanguan District, Changchun, Jilin, 130041, People's Republic of China.
Dan
D
Li
Department of Cardiovascular Surgery, The Second Hospital of Jilin University, 218 Ziqiang Street, Nanguan District, Changchun, Jilin, 130041, People's Republic of China.
Zhicheng
Z
Zhu
Department of Cardiovascular Surgery, The Second Hospital of Jilin University, 218 Ziqiang Street, Nanguan District, Changchun, Jilin, 130041, People's Republic of China.
Xiaomei
X
Zheng
Department of Cardiovascular Surgery, The First Hospital of Tianjin, No. 186 Nankou Road, Tianjin, 300232, People's Republic of China.
Weitie
W
Wang
Department of Cardiovascular Surgery, The Second Hospital of Jilin University, 218 Ziqiang Street, Nanguan District, Changchun, Jilin, 130041, People's Republic of China.
Rihao
R
Xu
Department of Cardiovascular Surgery, The Second Hospital of Jilin University, 218 Ziqiang Street, Nanguan District, Changchun, Jilin, 130041, People's Republic of China. kxliu64@hotmail.com.
Kexiang
K
Liu
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D058834:Gemella / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000382:microbiology*
D000900:Anti-Bacterial Agents
Atrial septal defect; Double-chambered right ventricle; Gemella morbillorum; Infective endocarditis; Ventricular septal defect