The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study
Abstract Background Finegoldia magna, a Gram-positive anaerobic coccus, is part of the human normal microbiota as a commensal of mucocutaneous surfaces. However, it remains an uncommon pathogen in infective endocarditis, with only eight clinical cases previously reported in the literature. Currently...
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s13019-019-0993-9 |
| _version_ | 1818047337094709248 |
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| author | Siobhan Chien David Gorman Charilaos-Panagiotis Koutsogiannidis Ramanish Ravishankar Ganesh Kamath Vipin Zamvar |
| author_facet | Siobhan Chien David Gorman Charilaos-Panagiotis Koutsogiannidis Ramanish Ravishankar Ganesh Kamath Vipin Zamvar |
| author_sort | Siobhan Chien |
| collection | DOAJ |
| description | Abstract Background Finegoldia magna, a Gram-positive anaerobic coccus, is part of the human normal microbiota as a commensal of mucocutaneous surfaces. However, it remains an uncommon pathogen in infective endocarditis, with only eight clinical cases previously reported in the literature. Currently, infective endocarditis is routinely treated with prolonged intravenous antibiotic therapy. However, recent research has found that switching patients to oral antibiotics is non-inferior to prolonged parenteral antibiotic treatment, challenging the current guidelines for the treatment of infective endocarditis. Case presentation This case report focuses on a 52-year-old gentleman, who presented with initially culture-negative infective endocarditis following bioprosthetic aortic valve replacement. Blood cultures later grew Finegoldia magna. Following initial intravenous antibiotic therapy and re-do surgical replacement of the prosthetic aortic valve, the patient was successfully switched to oral antibiotic monotherapy, an unusual strategy in the treatment of infective endocarditis inspired by the recent publication of the POET trial. He made excellent progress on an eight-week course of oral antibiotics and was successfully discharged from surgical follow-up. Conclusions This case is the 9th reported case of Finegoldia magna infective endocarditis in the literature. Our case also raises the possibility of a more patient-friendly and cost-effective means of providing long-term antibiotic therapy in suitable patients with prosthetic valve endocarditis and suggests that the principles highlighted in the POET trial can also be applicable to post-operative patients after cardiac surgery. |
| first_indexed | 2024-12-10T10:04:11Z |
| format | Article |
| id | doaj.art-5251ea9403ff439dbfd6444a26c01851 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-10T10:04:11Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-5251ea9403ff439dbfd6444a26c018512022-12-22T01:53:17ZengBMCJournal of Cardiothoracic Surgery1749-80902019-09-011411510.1186/s13019-019-0993-9The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case studySiobhan Chien0David Gorman1Charilaos-Panagiotis Koutsogiannidis2Ramanish Ravishankar3Ganesh Kamath4Vipin Zamvar5Department of Cardiothoracic Surgery, Royal Infirmary of EdinburghDepartment of Cardiothoracic Surgery, Royal Infirmary of EdinburghDepartment of Cardiothoracic Surgery, Royal Infirmary of EdinburghUniversity of EdinburghDepartment of Cardiothoracic Surgery, Kasturba Medical CollegeDepartment of Cardiothoracic Surgery, Royal Infirmary of EdinburghAbstract Background Finegoldia magna, a Gram-positive anaerobic coccus, is part of the human normal microbiota as a commensal of mucocutaneous surfaces. However, it remains an uncommon pathogen in infective endocarditis, with only eight clinical cases previously reported in the literature. Currently, infective endocarditis is routinely treated with prolonged intravenous antibiotic therapy. However, recent research has found that switching patients to oral antibiotics is non-inferior to prolonged parenteral antibiotic treatment, challenging the current guidelines for the treatment of infective endocarditis. Case presentation This case report focuses on a 52-year-old gentleman, who presented with initially culture-negative infective endocarditis following bioprosthetic aortic valve replacement. Blood cultures later grew Finegoldia magna. Following initial intravenous antibiotic therapy and re-do surgical replacement of the prosthetic aortic valve, the patient was successfully switched to oral antibiotic monotherapy, an unusual strategy in the treatment of infective endocarditis inspired by the recent publication of the POET trial. He made excellent progress on an eight-week course of oral antibiotics and was successfully discharged from surgical follow-up. Conclusions This case is the 9th reported case of Finegoldia magna infective endocarditis in the literature. Our case also raises the possibility of a more patient-friendly and cost-effective means of providing long-term antibiotic therapy in suitable patients with prosthetic valve endocarditis and suggests that the principles highlighted in the POET trial can also be applicable to post-operative patients after cardiac surgery.http://link.springer.com/article/10.1186/s13019-019-0993-9Finegoldia magnaProsthetic valve endocarditisOral antibioticsAdministrationCardiac surgical proceduresTreatment outcome |
| spellingShingle | Siobhan Chien David Gorman Charilaos-Panagiotis Koutsogiannidis Ramanish Ravishankar Ganesh Kamath Vipin Zamvar The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study Journal of Cardiothoracic Surgery Finegoldia magna Prosthetic valve endocarditis Oral antibiotics Administration Cardiac surgical procedures Treatment outcome |
| title | The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study |
| title_full | The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study |
| title_fullStr | The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study |
| title_full_unstemmed | The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study |
| title_short | The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study |
| title_sort | novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by finegoldia magna a case study |
| topic | Finegoldia magna Prosthetic valve endocarditis Oral antibiotics Administration Cardiac surgical procedures Treatment outcome |
| url | http://link.springer.com/article/10.1186/s13019-019-0993-9 |
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