Staphylococcus Lugdunensis: The "lyon Heart" Pathogen Report Of 5 Cases Of Endocarditis And Review Of The Adult Literature
bacteremia; clinical-experience; Immunology; Infectious Diseases; infective endocarditis; lead endocarditis; native-valve; of-the-literature; pacemaker; prosthetic valve; pulmonary valve endocarditis; Staphylococcus lugdunensis; vasectomy
Staphylococcus lugdunensis is a coagulase-negative Staphylococcus capable of causing infective endocarditis on native as well as prosthetic valves and implanted cardiac devices. It causes acute disease clinically indistinguishable from that caused by Staphylococcus aureus. Bacteremic infections with S. lugdunensis have a high incidence of associated infective endocarditis. Many S. lugdunensis isolates are exquisitely sensitive to penicillin G. Endocarditis caused by S. lugdunensis frequently requires surgical intervention and has a high mortality rate. Case 1: A 48-year-old woman with mitral valve prolapse, S. lugdunensis bacteremia and mitral valve endocarditis. She underwent emergent mitral valve replacement and completed treatment with intravenous nafcillin. Case 2: A 31-year-old woman with spontaneous S. lugdunensis bacteremia and tricuspid valve endocarditis. She was successfully treated medically with 6 weeks of intravenous nafcillin. Case 3: A 44-year-old man with S. lugdunensis endocarditis on congenital bicuspid aortic valve with severe aortic insufficiency. He underwent emergent aortic valve replacement and successfully completed 6 weeks of intravenous nafcillin. Case 4: A 37-year-old woman with spontaneous S. lugdunensis bacteremia and native aortic valve endocarditis. She was successfully treated medically with 6 weeks of intravenous vancomycin. Case 5: A 57-year-old woman with hemodialysis catheter-related S. lugdunensis bacteremia and native mitral valve endocarditis. She was successfully treated medically with 6 weeks of intravenous cefazolin. Staphylococcus lugdunensis is a unique coagulase-negative Staphylococcus first identified in Lyon, France, the modern name for the Roman city of Lugdunum, ergo the organism's name. Since its identification, S. lugdunensis has been described as a "Lion among coagulase-negative staphylococci" and as "a dangerous wolf in sheep's clothing" because of the tendency of clinicians to initially discount positive blood cultures with " coagulase-negative staphylococci" as probable skin contaminants and thereby delay appropriate antimicrobial therapy. We report 5 patients with S. lugdunensis endocarditis and review the adult literature for other reported cases.
Kline J A; Byrnes T J; Myers J P
Infectious Diseases in Clinical Practice
2017
2017-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/ipc.0000000000000459" target="_blank" rel="noreferrer noopener">10.1097/ipc.0000000000000459</a>
Utility of Intracardiac Echocardiography to Diagnose Infective Endocarditis.
infective endocarditis; intracardiac echography; prosthetic valve
Infective endocarditis (IE) can lead to significant morbidity and mortality without appropriate treatment. Modified Duke Criteria are accepted by many professional societies to establish the diagnosis of IE, and cardiac imaging is one of the major diagnostic criteria. Transesophageal echocardiography is an algorithmic escalation to diagnose IE when transthoracic echo does not appreciate a positive finding. In patients with contraindications to transesophageal echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography (CT), cardiac CT angiography, and fluorodeoxyglucose positron emission tomography with CT or CT angiography may be alternative diagnostic tools. However, these imaging modalities have their own limitations such as local unavailability, the presence of non-magnetic resonance imaging compatible implants, or impaired renal function. Intracardiac echocardiography could be a considerable alternative under those circumstances.
Yang Ying Chi; Aung Thein Tun; Khan Sarah; Wase Abdul
Journal of investigative medicine high impact case reports
2019
2019-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/2324709618822075" target="_blank" rel="noreferrer noopener">10.1177/2324709618822075</a>