ABSTRACT
Infective endocarditis caused by Abiotrophia defectiva is rarely encountered. A 67-year-old male transferred from a local hospital presented with severe dyspnea and pulmonary edema. Preoperative transthoracic echocardiography revealed severe mitral regurgitation with large vegetation. Blood cultures grew A. defectiva, a gram positive, nutritionally deficient streptococcus variant. Emergent mitral valve replacement through right thoracotomy was performed, and after completing six weeks of antibiotic combination therapy (vancomycin, ampicillin, and gentamicin), the patient recovered fully. Because of the need for prompt surgical treatment and long-term antibiotic therapy and lack of laboratory experience with the organism, physicians and laboratory workers should pay close attention to the possibility of A. defectiva infective endocarditis when gram positive cocci are detected in blood cultures.
Subject(s)
Adult , Aged , Humans , Male , Abiotrophia , Ampicillin , Dyspnea , Echocardiography , Endocarditis , Endocarditis, Bacterial , Gram-Positive Cocci , Mitral Valve , Mitral Valve Insufficiency , Pulmonary Edema , Streptococcus , ThoracotomyABSTRACT
Granulicatella species are nutritionally variant streptococci first described in 1961. Granulicatella species form a part of the normal flora of the oral cavity, genitourinary tract, and intestinal tract. These micro-organisms cause bacteremia or local infections such as endocarditis, central nervous system infections, arthritis, and osteomyelitis. Since isolation of Granulicatella species is difficult, only a few cases of infection caused by this microorganism have been reported. Herein, we report a case of endocarditis caused by Granulicatella adiacens in a 46-year-old patient with ventricular septal defect.
Subject(s)
Humans , Middle Aged , Arthritis , Bacteremia , Central Nervous System Infections , Endocarditis , Heart Septal Defects, Ventricular , Mouth , OsteomyelitisABSTRACT
Granulicatella adiacens is one of the fastidious gram positive cocci previously described as nutritionally variant streptococci due to their requirement of L-cysteine, pyridoxal, or thiol compounds for growth. These bacteria have been identified as significant causative agents of endocarditis, opthalmic infections, and meningitis. We report a case of septicemia caused by G. adiacens in an 80-year-old patient with cholangiocarcinoma. The organism was identified by phenotypic and 16S rRNA sequencing analyses.
Subject(s)
Aged, 80 and over , Humans , Bacteria , Cholangiocarcinoma , Cysteine , Endocarditis , Gram-Positive Cocci , Meningitis , Pyridoxal , SepsisABSTRACT
Granulicatella adiacens was first described as nutritionally variant streptococci, and named as Streptococcus adjacens and Abiotrophia adiacens. Granulicatella species are flora of oral cavity, upper respiratory, urogenital, and gastrointestinal tracts, and are normal often isolated from patients with infective endocarditis. G. adiacens endocarditis is associated with high mortality, but the species hardly grow in the ordinary growth media. We report a case of septicemia caused by G. adiacens in a 52-year-old woman with liver cirrhosis and chronic renal failure.
Subject(s)
Female , Humans , Middle Aged , Abiotrophia , Endocarditis , Gastrointestinal Tract , Kidney Failure, Chronic , Liver Cirrhosis , Mortality , Mouth , Sepsis , StreptococcusABSTRACT
Granulicatella adiacens was first described as nutritionally variant streptococci, and named as Streptococcus adjacens and Abiotrophia adiacens. Granulicatella species are flora of oral cavity, upper respiratory, urogenital, and gastrointestinal tracts, and are normal often isolated from patients with infective endocarditis. G. adiacens endocarditis is associated with high mortality, but the species hardly grow in the ordinary growth media. We report a case of septicemia caused by G. adiacens in a 52-year-old woman with liver cirrhosis and chronic renal failure.