Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease

A 45-year-old male with a prosthetic aortic valve presented to the hospital with several months of generalized malaise. On admission, he was noted to have anemia of unclear etiology and subsequently became febrile with multiple blood cultures growing Lactococcus garvieae. Inpatient workup was concer...

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Main Authors: Taylor C. Bazemore, Stacey A. Maskarinec, Kahli Zietlow, Edward F. Hendershot, John R. Perfect
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2016/5805326
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author Taylor C. Bazemore
Stacey A. Maskarinec
Kahli Zietlow
Edward F. Hendershot
John R. Perfect
author_facet Taylor C. Bazemore
Stacey A. Maskarinec
Kahli Zietlow
Edward F. Hendershot
John R. Perfect
author_sort Taylor C. Bazemore
collection DOAJ
description A 45-year-old male with a prosthetic aortic valve presented to the hospital with several months of generalized malaise. On admission, he was noted to have anemia of unclear etiology and subsequently became febrile with multiple blood cultures growing Lactococcus garvieae. Inpatient workup was concerning for infectious endocarditis (IE) secondary to Lactococcus. The patient was discharged home with appropriate antimicrobial therapy; however, he was readmitted for persistent, symptomatic anemia and underwent colonoscopy, which revealed innumerable colonic polyps consistent with Familial Adenomatous Polyposis (FAP) that was later confirmed with genetic testing. Surveillance computed tomography (CT) imaging of the aortic repair later demonstrated valve dehiscence with surrounding fluid collection; he underwent redo surgery and was found to have destruction of the aortic annulus and a large pseudoaneurysm. Histopathology of the valve prosthesis confirmed IE. It is suspected that the patient developed Lactococcus IE from enteric translocation. Review of the literature provides several reports of Lactococcus infections in association with underlying gastrointestinal disease, including colorectal cancer. Given this association, we raise the question of whether the diagnosis of Lactococcus IE should evoke suspicion and encourage evaluation for gastrointestinal pathology, as occurs with Streptococcus bovis.
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spelling doaj-art-eabc761033c342ecba45fe974fbf63d42025-08-20T03:20:39ZengWileyCase Reports in Infectious Diseases2090-66252090-66332016-01-01201610.1155/2016/58053265805326Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal DiseaseTaylor C. Bazemore0Stacey A. Maskarinec1Kahli Zietlow2Edward F. Hendershot3John R. Perfect4Department of Internal Medicine, Duke University Hospital, Durham, NC, USADivision of Infectious Diseases, Department of Internal Medicine, Duke University Hospital, Durham, NC, USADepartment of Internal Medicine, Duke University Hospital, Durham, NC, USADivision of Infectious Diseases, Department of Internal Medicine, Duke University Hospital, Durham, NC, USADivision of Infectious Diseases, Department of Internal Medicine, Duke University Hospital, Durham, NC, USAA 45-year-old male with a prosthetic aortic valve presented to the hospital with several months of generalized malaise. On admission, he was noted to have anemia of unclear etiology and subsequently became febrile with multiple blood cultures growing Lactococcus garvieae. Inpatient workup was concerning for infectious endocarditis (IE) secondary to Lactococcus. The patient was discharged home with appropriate antimicrobial therapy; however, he was readmitted for persistent, symptomatic anemia and underwent colonoscopy, which revealed innumerable colonic polyps consistent with Familial Adenomatous Polyposis (FAP) that was later confirmed with genetic testing. Surveillance computed tomography (CT) imaging of the aortic repair later demonstrated valve dehiscence with surrounding fluid collection; he underwent redo surgery and was found to have destruction of the aortic annulus and a large pseudoaneurysm. Histopathology of the valve prosthesis confirmed IE. It is suspected that the patient developed Lactococcus IE from enteric translocation. Review of the literature provides several reports of Lactococcus infections in association with underlying gastrointestinal disease, including colorectal cancer. Given this association, we raise the question of whether the diagnosis of Lactococcus IE should evoke suspicion and encourage evaluation for gastrointestinal pathology, as occurs with Streptococcus bovis.http://dx.doi.org/10.1155/2016/5805326
spellingShingle Taylor C. Bazemore
Stacey A. Maskarinec
Kahli Zietlow
Edward F. Hendershot
John R. Perfect
Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease
Case Reports in Infectious Diseases
title Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease
title_full Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease
title_fullStr Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease
title_full_unstemmed Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease
title_short Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease
title_sort familial adenomatous polyposis manifesting as lactococcus endocarditis a case report and review of the association of lactococcus with underlying gastrointestinal disease
url http://dx.doi.org/10.1155/2016/5805326
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