1887

Abstract

We report an unusual case of endocarditis occurring in a 74-year-old man with a history of systemic hypertension, diabetes mellitus and minor amputation for left forefoot ulcer. The patient was hospitalized for vacuum-assisted closure therapy to aid in wound healing. After the first treatment session, the patient reported abdominal pain with haematemesis and fever (40 °C). Owing to persistent fever, three blood cultures were performed, all positive for . The identification was based on biochemical tests and automated systems. The speciation of the micro-organism was achieved with MALDI-TOF and then confirmed by 16S rRNA gene sequencing. Transthoracic echocardiographic examination showed the presence of a large vegetation (38×20 mm) on the posterior mitral leaflet and moderate mitral regurgitation. Since there are no current guidelines for the treatment of endocarditis, empiric antibiotic therapy with intravenous sulbactam/ampicillin (1.5 g twice daily) and gentamicin (6 mg kg per day) was started. After 7 days of hospitalization, the patient’s condition suddenly worsened because of the occurrence of haemorrhagic stroke. Despite inotropic support and rifampicin infusion, the haemodynamic status progressively deteriorated. After an initial improvement, he worsened again, becoming stuporous, hypotensive and dyspnoeic. In the following days, the patient developed compartment syndrome resulting in right foot ischaemia. Unfortunately, 25 days after hospitalization, the patient died of multiple organ failure from overwhelming sepsis. To the best of our knowledge, this is the first case of endocarditis on a native valve that is not related to a central venous catheter but associated with diabetic foot infection.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.054536-0
2013-06-01
2019-09-15
Loading full text...

Full text loading...

/deliver/fulltext/jmm/62/6/932.html?itemId=/content/journal/jmm/10.1099/jmm.0.054536-0&mimeType=html&fmt=ahah

References

  1. Basaglia G., Carretto E., Barbarini D., Moras L., Scalone S., Marone P., De Paoli P.. ( 2002;). Catheter-related bacteremia due to Kocuria kristinae in a patient with ovarian cancer. . J Clin Microbiol 40:, 311–313. [CrossRef][PubMed]
    [Google Scholar]
  2. Ben-Ami R., Navon-Venezia S., Schwartz D., Schlezinger Y., Mekuzas Y., Carmeli Y.. ( 2005;). Erroneous reporting of coagulase-negative Staphylococci as Kocuria spp. by the Vitek 2 system. . J Clin Microbiol 43:, 1448–1450. [CrossRef][PubMed]
    [Google Scholar]
  3. Carlini A., Mattei R., Lucarotti I., Bartelloni A., Rosati A.. ( 2011;). Kocuria kristinae: an unusual cause of acute peritoneal dialysis-related infection. . Perit Dial Int 31:, 105–107. [CrossRef][PubMed]
    [Google Scholar]
  4. Cheung C. Y., Cheng N. H., Chau K. F., Li C. S.. ( 2011;). An unusual organism for CAPD-related peritonitis: Kocuria kristinae. . Perit Dial Int 31:, 107–108. [CrossRef][PubMed]
    [Google Scholar]
  5. Dunn R., Bares S., David M. Z.. ( 2011;). Central venous catheter-related bacteremia caused by Kocuria kristinae: case report and review of the literature. . Ann Clin Microbiol Antimicrob 10:, 31. [CrossRef][PubMed]
    [Google Scholar]
  6. Lai C. C., Wang J. Y., Lin S. H., Tan C. K., Wang C. Y., Liao C. H., Chou C. H., Huang Y. T., Lin H. I., Hsueh P. R.. ( 2011;). Catheter-related bacteraemia and infective endocarditis caused by Kocuria species. . Clin Microbiol Infect 17:, 190–192. [CrossRef][PubMed]
    [Google Scholar]
  7. Ma E. S. K., Wong C. L. P., Lai K. T. W., Chan E. C. H., Yam W. C., Chan A. C. W.. ( 2005;). Kocuria kristinae infection associated with acute cholecystitis. . BMC Infect Dis 5:, 60. [CrossRef][PubMed]
    [Google Scholar]
  8. Martinaud C., Gisserot O., Gaillard T., Brisou P., de Jaureguiberry J. P.. ( 2008;). [Bactériémie à Kocuria kristinae au cours d’une leucémie aiguë]. . Med Mal Infect 38:, 334–335 (in French).[PubMed]
    [Google Scholar]
  9. Oncel E. K., Boyraz M. S., Kara A.. ( 2012;). Black tongue associated with Kocuria (Micrococcus) kristinae bacteremia in a 4-month-old infant. . Eur J Pediatr 171:, 593. [CrossRef][PubMed]
    [Google Scholar]
  10. Stackebrandt E., Koch C., Gvozdiak O., Schumann P.. ( 1995;). Taxonomic dissection of the genus Micrococcus: Kocuria gen. nov., Nesterenkonia gen. nov., Kytococcus gen. nov., Dermacoccus gen. nov., and Micrococcus Cohn 1872 gen. emend. . Int J Syst Bacteriol 45:, 682–692. [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.054536-0
Loading
/content/journal/jmm/10.1099/jmm.0.054536-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error