Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement
Lactococcus garvieae is a fish pathogen and an uncommon cause of human infections. There is a growing body of evidence showing its potential for causing endocarditis especially in those with prior valve surgery. In this case report, we present what we believe is the first case of endocarditis by L....
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2021/5569533 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560661343764480 |
|---|---|
| author | Diego H. González-Bravo Sergio Alegre-Boschetti Richard Silva-Cantillo Joshua Mercado-Maldonado Reyshley Ramos-Márquez Gabriel Torres-Rivera Carlos Cortés Josue Mercado-Crespo |
| author_facet | Diego H. González-Bravo Sergio Alegre-Boschetti Richard Silva-Cantillo Joshua Mercado-Maldonado Reyshley Ramos-Márquez Gabriel Torres-Rivera Carlos Cortés Josue Mercado-Crespo |
| author_sort | Diego H. González-Bravo |
| collection | DOAJ |
| description | Lactococcus garvieae is a fish pathogen and an uncommon cause of human infections. There is a growing body of evidence showing its potential for causing endocarditis especially in those with prior valve surgery. In this case report, we present what we believe is the first case of endocarditis by L. garvieae affecting a valve-in-valve transcatheter aortic valve replacement that was successfully treated. Specific guidelines for the management of these patients are lacking. Our experience can contribute to the current knowledge regarding this life-threatening infection as well as to the future care of these patients. We aim to emphasize that despite not being recognized as a typical endocarditis microorganism by the Duke Criteria, the possibility of endocarditis needs to be highly entertained in patients with L. garvieae bacteremia, especially when prosthetic valves are present. Consequently, clinicians should pursue further this diagnosis with transesophageal echocardiogram and/or alternative imaging modalities (e.g., PET-CT scan and MRI) regardless of an initial negative transthoracic echocardiogram. Reaching a diagnosis of L. garvieae endocarditis led us to the decision of prolonging the antibiotic course for 6 weeks with successful results. Ultimately, surgery was not required owing to the absence of prosthetic aortic valve dysfunction and paravalvular extension of the infection. |
| format | Article |
| id | doaj-art-4699adc9f09448c4bf1e7bf2f3766fd1 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-4699adc9f09448c4bf1e7bf2f3766fd12025-02-03T01:26:58ZengWileyCase Reports in Cardiology2090-64042090-64122021-01-01202110.1155/2021/55695335569533Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve ReplacementDiego H. González-Bravo0Sergio Alegre-Boschetti1Richard Silva-Cantillo2Joshua Mercado-Maldonado3Reyshley Ramos-Márquez4Gabriel Torres-Rivera5Carlos Cortés6Josue Mercado-Crespo7Cardiovascular Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoCardiovascular Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoCardiovascular Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoCardiovascular Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoInternal Medicine Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoInternal Medicine Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoInternal Medicine and Nephrology Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoCardiovascular Division, Department of Medicine, VA Caribbean Healthcare System, San Juan, Puerto RicoLactococcus garvieae is a fish pathogen and an uncommon cause of human infections. There is a growing body of evidence showing its potential for causing endocarditis especially in those with prior valve surgery. In this case report, we present what we believe is the first case of endocarditis by L. garvieae affecting a valve-in-valve transcatheter aortic valve replacement that was successfully treated. Specific guidelines for the management of these patients are lacking. Our experience can contribute to the current knowledge regarding this life-threatening infection as well as to the future care of these patients. We aim to emphasize that despite not being recognized as a typical endocarditis microorganism by the Duke Criteria, the possibility of endocarditis needs to be highly entertained in patients with L. garvieae bacteremia, especially when prosthetic valves are present. Consequently, clinicians should pursue further this diagnosis with transesophageal echocardiogram and/or alternative imaging modalities (e.g., PET-CT scan and MRI) regardless of an initial negative transthoracic echocardiogram. Reaching a diagnosis of L. garvieae endocarditis led us to the decision of prolonging the antibiotic course for 6 weeks with successful results. Ultimately, surgery was not required owing to the absence of prosthetic aortic valve dysfunction and paravalvular extension of the infection.http://dx.doi.org/10.1155/2021/5569533 |
| spellingShingle | Diego H. González-Bravo Sergio Alegre-Boschetti Richard Silva-Cantillo Joshua Mercado-Maldonado Reyshley Ramos-Márquez Gabriel Torres-Rivera Carlos Cortés Josue Mercado-Crespo Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement Case Reports in Cardiology |
| title | Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement |
| title_full | Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement |
| title_fullStr | Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement |
| title_full_unstemmed | Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement |
| title_short | Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter Aortic Valve Replacement |
| title_sort | lactococcus garvieae an uncommon human pathogen causing infective endocarditis in a valve in valve transcatheter aortic valve replacement |
| url | http://dx.doi.org/10.1155/2021/5569533 |
| work_keys_str_mv | AT diegohgonzalezbravo lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement AT sergioalegreboschetti lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement AT richardsilvacantillo lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement AT joshuamercadomaldonado lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement AT reyshleyramosmarquez lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement AT gabrieltorresrivera lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement AT carloscortes lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement AT josuemercadocrespo lactococcusgarvieaeanuncommonhumanpathogencausinginfectiveendocarditisinavalveinvalvetranscatheteraorticvalvereplacement |