1887

Abstract

Introduction:

, a Gram-variable, rod-shaped organism, was previously thought to be non-pathogenic. However, in recent years it has become increasingly recognized as a rare cause of infective endocarditis. Here, to the best of our knowledge, we describe the first case of bivalvular prosthetic valve endocarditis due to .

Case Presentation:

A 55-year-old Taiwanese man with history of endocarditis status post prosthetic mitral and aortic valve replacements presented with a 2-week history of progressive fatigue and altered mental status. He presented with fever, lethargy and shock. He was intubated and started on vasopressors. A systolic murmur was noted with leukocytosis and acute renal failure. He was started on broad-spectrum antibiotics. An initial trans-oesophageal echocardiogram (TOE) did not reveal vegetation, but showed an elevated aortic valve gradient of 70 mmHg consistent with severe aortic stenosis. A repeat TOE revealed multiple mobile and immobile mitral and aortic valve vegetations with an abscess extending toward the aortic valve. Three sets of positive blood cultures from admission identified . Antibiotics were tailored to ceftriaxone. He underwent urgent aortic and mitral valve replacement. He completed a 6-week course of ceftriaxone. At discharge, two-dimensional echo revealed normal heart function with normal prosthetic mitral and aortic valves.

Conclusion:

is an uncommon, but increasingly recognized, cause of infective endocarditis. It causes severe valvular destruction with systemic complications and often requires surgical intervention.

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2015-10-09
2020-04-08
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References

  1. Andersen B. M., Weyant R. S., Steigerwalt A. G., Moss C. W., Hollis D. G., Weaver R. E., Ashford D., Brenner D. J.. 1995; Characterization of Neisseria elongata subsp. glycolytica isolates obtained from human wound specimens and blood cultures. J Clin Microbiol33:76–78[PubMed]
    [Google Scholar]
  2. Apisarnthanarak A., Dunagan W. C., Dunne W. M. Jr. 2001; Neisseria elongata subsp. elongata, as a cause of human endocarditis. Diagn Microbiol Infect Dis39:265–266 [CrossRef][PubMed]
    [Google Scholar]
  3. Cervera J. I., Todolí J. A., Sauquillo J. M., Calabuig E.. 2004; [Endocarditis due to the Neisseria elongata subspecies nitroreducens]. Enferm Infecc Microbiol Clin22:556–557 (in Spanish)[CrossRef]
    [Google Scholar]
  4. Dominguez E. A., Smith T. L.. 1998; Endocarditis due to Neisseria elongata subspecies nitroreducens: case report and review. Clin Infect Dis26:1471–1473 [CrossRef][PubMed]
    [Google Scholar]
  5. Evans M., Yazdani F., Malnick H., Shah J. J., Turner D. P.. 2007; Prosthetic valve endocarditis due to Neisseria elongata subsp. elongata in a patient with Klinefelter's syndrome. J Med Microbiol56:860–862 [CrossRef][PubMed]
    [Google Scholar]
  6. Garner J., Briant R. H.. 1986; Osteomyelitis caused by a bacterium known as M6. J Infect13:298–300 [CrossRef][PubMed]
    [Google Scholar]
  7. Grant P. E., Brenner D. J., Steigerwalt A. G., Hollis D. G., Weaver R. E.. 1990; Neisseria elongata subsp. nitroreducens subsp. nov., formerly CDC group M-6, a gram-negative bacterium associated with endocarditis. J Clin Microbiol28:2591–2596[PubMed]
    [Google Scholar]
  8. Haddow L. J., Mulgrew C., Ansari A., Miell J., Jackson G., Malnick H., Rao G. G.. 2003; Neisseria elongata endocarditis: case report and literature review. Clin Microbiol Infect9:426–430 [CrossRef][PubMed]
    [Google Scholar]
  9. Hofstad T., Hope O., Falsen E.. 1998; Septicaemia with Neisseria elongata ssp. nitroreducens in a patient with hypertrophic obstructive cardiomyopathia. Scand J Infect Dis30:200–201 [CrossRef][PubMed]
    [Google Scholar]
  10. Hoshino T., Ohkusu K., Sudo F., Nakajima H., Ishiwada N., Ezaki T., Kohno Y.. 2005; Neisseria elongata subsp. nitroreducens endocarditis in a seven-year-old boy. Pediatr Infect Dis J24:391–392 [CrossRef][PubMed]
    [Google Scholar]
  11. Hsiao J. F., Lee M. H., Chia J. H., Ho W. J., Chu J. J., Chu P. H.. 2008; Neisseria elongata endocarditis complicated by brain embolism and abscess. J Med Microbiol57:376–381 [CrossRef][PubMed]
    [Google Scholar]
  12. Imperial H. L., Joho K. L., Alcid D. V.. 1995; Endocarditis due to Neisseria elongata subspecies nitroreducens . Clin Infect Dis20:1431–1432 [CrossRef][PubMed]
    [Google Scholar]
  13. Kaplan L. J., Flaherty J.. 1991; Centers for Disease Control Group M-6: a cause of destructive endocarditis. J Infect Dis
    [Google Scholar]
  14. Kociuba K., Munro R., Daley D.. 1993; M-6 endocarditis: report of an Australian case. Pathology25:310–312 [CrossRef][PubMed]
    [Google Scholar]
  15. Meuleman P., Verhaegen J., Erard K., Herregods M. C., Peetermans W. E.. 1996; Bioprosthetic valve endocarditis caused by Neisseria elongata subspecies nitroreducens . Infection24:258–260 [CrossRef][PubMed]
    [Google Scholar]
  16. Nawaz T., Hardy D. J., Bonnez W.. 1996; Neisseria elongata subsp. elongata, a case of human endocarditis complicated by pseudoaneurysm. J Clin Microbiol34:756–758[PubMed]
    [Google Scholar]
  17. Noheria A., Anderson P., Tapia-Zegarra G., Baddour L., Wilson W.. 2010; Infective endocarditis due to Neisseria elongata . Infect Dis Clin Pract18:355–358 [CrossRef]
    [Google Scholar]
  18. Ota T., Gleason T. G., Salizzoni S., Wei L. M., Toyoda Y., Bermudez C.. 2011; Midterm surgical outcomes of noncomplicated active native multivalve endocarditis: single-center experience. Ann Thorac Surg91:1414–1419 [CrossRef][PubMed]
    [Google Scholar]
  19. Perez R. E.. 1986; Endocarditis with Moraxella-like M-6 after cardiac catheterization. J Clin Microbiol24:501–502[PubMed]
    [Google Scholar]
  20. Picu C., Mille C., Popescu G. A., Bret L., Prazuck T.. 2003; Aortic prosthetic endocarditis with Neisseria elongata subspecies nitroreducens . Scand J Infect Dis35:280–282 [CrossRef][PubMed]
    [Google Scholar]
  21. Rose R. C. III, Grossman A. M., Giles J. W.. 1990; Infective endocarditis due to the CDC group M6 bacillus. J Tenn Med Assoc83:603–604[PubMed]
    [Google Scholar]
  22. Simor A. E., Salit I. E.. 1983; Endocarditis caused by M6. J Clin Microbiol17:931–933[PubMed]
    [Google Scholar]
  23. Struillou L., Raffi F., Barrier J. H.. 1993; Endocarditis caused by Neisseria elongata subspecies nitroreducens: case report and literature review. Eur J Clin Microbiol Infect Dis12:625–627 [CrossRef][PubMed]
    [Google Scholar]
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