An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremia
Abstract The patient is an 82‐year‐old male with a past medical history of aortic valve replacement who presented to the emergency department after a fall. He developed atrial fibrillation with a rapid ventricular response and non–ST‐segment–elevation myocardial infarction, leading to hospitalizatio...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12821 |
| _version_ | 1811247906775105536 |
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| author | Safiyah Noor Zubair Soofia Kisana Cynthia J. Anneski Imtiaz Ahmed Sajjad Ashraf Minhas |
| author_facet | Safiyah Noor Zubair Soofia Kisana Cynthia J. Anneski Imtiaz Ahmed Sajjad Ashraf Minhas |
| author_sort | Safiyah Noor Zubair |
| collection | DOAJ |
| description | Abstract The patient is an 82‐year‐old male with a past medical history of aortic valve replacement who presented to the emergency department after a fall. He developed atrial fibrillation with a rapid ventricular response and non–ST‐segment–elevation myocardial infarction, leading to hospitalization. During hospital admission, the patient complained of midline thoracic back pain, and an extensive evaluation for this complaint revealed discitis and osteomyelitis with epidural abscess near the T7 and T8 vertebrae that did not result in neurological deficits and required no surgical intervention. A total of 2 blood cultures were reported positive for Actinomyces naeslundii, Streptococcus mitis, Streptococcus oralis, and Abiotrophia defectiva. A transesophageal echocardiogram showed a small vegetation on the aortic prosthetic valve with probable small vegetation on the mitral valve. He was prescribed ceftriaxone intravenously for 12 weeks, followed by amoxicillin 2 g orally twice a day for at least 12 months. A. naeslundii is not commonly known to cause infective endocarditis, whereas S. mitis, S. oralis, and A. defectiva have been reported to do so. One previous case of A. naeslundii was reported to cause prosthetic valve endocarditis as a single infectious agent. To our knowledge, this is the first case report for A. naeslundii as part of multimicrobial bacteremia leading to endocarditis, discitis, and osteomyelitis. |
| first_indexed | 2024-04-12T15:17:47Z |
| format | Article |
| id | doaj.art-c1887bcdb7b94b76bdda152c824d5644 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-04-12T15:17:47Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-c1887bcdb7b94b76bdda152c824d56442022-12-22T03:27:34ZengWileyJournal of the American College of Emergency Physicians Open2688-11522022-10-0135n/an/a10.1002/emp2.12821An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremiaSafiyah Noor Zubair0Soofia Kisana1Cynthia J. Anneski2Imtiaz Ahmed3Sajjad Ashraf Minhas4Arizona State University Tempe Arizona USAArizona State University Tempe Arizona USADepartment of Infectious Disease Mountain Vista Medical Center Mesa Arizona USADepartment of Radiology Tempe St. Luke's Hospital, Mountain Vista Medical Center Mesa Arizona USADepartment of Emergency Medicine Tempe St. Luke's Hospital Tempe Arizona USAAbstract The patient is an 82‐year‐old male with a past medical history of aortic valve replacement who presented to the emergency department after a fall. He developed atrial fibrillation with a rapid ventricular response and non–ST‐segment–elevation myocardial infarction, leading to hospitalization. During hospital admission, the patient complained of midline thoracic back pain, and an extensive evaluation for this complaint revealed discitis and osteomyelitis with epidural abscess near the T7 and T8 vertebrae that did not result in neurological deficits and required no surgical intervention. A total of 2 blood cultures were reported positive for Actinomyces naeslundii, Streptococcus mitis, Streptococcus oralis, and Abiotrophia defectiva. A transesophageal echocardiogram showed a small vegetation on the aortic prosthetic valve with probable small vegetation on the mitral valve. He was prescribed ceftriaxone intravenously for 12 weeks, followed by amoxicillin 2 g orally twice a day for at least 12 months. A. naeslundii is not commonly known to cause infective endocarditis, whereas S. mitis, S. oralis, and A. defectiva have been reported to do so. One previous case of A. naeslundii was reported to cause prosthetic valve endocarditis as a single infectious agent. To our knowledge, this is the first case report for A. naeslundii as part of multimicrobial bacteremia leading to endocarditis, discitis, and osteomyelitis.https://doi.org/10.1002/emp2.12821ActinomycesActinomyces naeslundiiactinomycosismultimicrobial bacteremiainfective endocarditisindium WBC scan |
| spellingShingle | Safiyah Noor Zubair Soofia Kisana Cynthia J. Anneski Imtiaz Ahmed Sajjad Ashraf Minhas An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremia Journal of the American College of Emergency Physicians Open Actinomyces Actinomyces naeslundii actinomycosis multimicrobial bacteremia infective endocarditis indium WBC scan |
| title | An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremia |
| title_full | An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremia |
| title_fullStr | An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremia |
| title_full_unstemmed | An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremia |
| title_short | An 82‐year‐old man with a prosthetic aortic valve and multimicrobial bacteremia |
| title_sort | 82 year old man with a prosthetic aortic valve and multimicrobial bacteremia |
| topic | Actinomyces Actinomyces naeslundii actinomycosis multimicrobial bacteremia infective endocarditis indium WBC scan |
| url | https://doi.org/10.1002/emp2.12821 |
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