Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves
Staphylococcus lugdunensis (S. lugdunensis) is a coagulase negative staphylococcus (CoNS) that can cause destructive infective endocarditis. S. lugdunensis, unlike other CoNS, should be considered to be a pathogen. We report the first case of S. lugdunensis endocarditis causing ventricular septal de...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-01-01
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| Series: | IDCases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250916301184 |
| _version_ | 1819150332685451264 |
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| author | Celestine Ishiekwene Monica Ghitan Margaret Kuhn-Basti Edward Chapnick Yu Shia Lin |
| author_facet | Celestine Ishiekwene Monica Ghitan Margaret Kuhn-Basti Edward Chapnick Yu Shia Lin |
| author_sort | Celestine Ishiekwene |
| collection | DOAJ |
| description | Staphylococcus lugdunensis (S. lugdunensis) is a coagulase negative staphylococcus (CoNS) that can cause destructive infective endocarditis. S. lugdunensis, unlike other CoNS, should be considered to be a pathogen. We report the first case of S. lugdunensis endocarditis causing ventricular septal defect and destruction of the aortic and mitral valves.
A 53-year-old male with morbid obesity and COPD presented with intermittent fever and progressive shortness of breath for 2 weeks.
Chest examination showed bilateral basal crepitations, and a grade 2 systolic murmur along the right sternal border. The leukocyte count was 26,000 cells/μl with 89% neutrophils. He was treated with intravenous vancomycin and ceftriaxone. Blood cultures grew Staphylococcus lugdunensis. Transthoracic echocardiogram, which was limited by body habitus, showed no definite valvular vegetations. Repeat transthoracic echocardiogram performed one week later revealed a large aortic valve vegetation Vancomycin was switched to daptomycin on day 4 because of difficulty achieving therapeutic levels of vancomycin and the development of renal insufficiency.
Open heart surgery on day 10 revealed aortic valve and mitral valve vegetations with destruction, left ventricular outflow tract (LVOT) septal abscess and ventricular septal defect (VSD). Bio-prosthetic aortic and mitral valve replacement, LVOT and VSD repair were done. Intraoperative cultures grew Staphylococcus lugdunensis. The patient was discharged home with daptomycin to complete 6 weeks of treatment.
S. lugdunensis can cause rapidly progressive endocarditis with valve and septal destruction. Early diagnosis and therapy are essential, with consideration of valve replacement. |
| first_indexed | 2024-12-22T14:15:49Z |
| format | Article |
| id | doaj.art-f01a066f3e034124883a9191938d60ea |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-12-22T14:15:49Z |
| publishDate | 2017-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-f01a066f3e034124883a9191938d60ea2022-12-21T18:23:07ZengElsevierIDCases2214-25092017-01-017C141510.1016/j.idcr.2016.10.011Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valvesCelestine IshiekweneMonica GhitanMargaret Kuhn-BastiEdward ChapnickYu Shia LinStaphylococcus lugdunensis (S. lugdunensis) is a coagulase negative staphylococcus (CoNS) that can cause destructive infective endocarditis. S. lugdunensis, unlike other CoNS, should be considered to be a pathogen. We report the first case of S. lugdunensis endocarditis causing ventricular septal defect and destruction of the aortic and mitral valves. A 53-year-old male with morbid obesity and COPD presented with intermittent fever and progressive shortness of breath for 2 weeks. Chest examination showed bilateral basal crepitations, and a grade 2 systolic murmur along the right sternal border. The leukocyte count was 26,000 cells/μl with 89% neutrophils. He was treated with intravenous vancomycin and ceftriaxone. Blood cultures grew Staphylococcus lugdunensis. Transthoracic echocardiogram, which was limited by body habitus, showed no definite valvular vegetations. Repeat transthoracic echocardiogram performed one week later revealed a large aortic valve vegetation Vancomycin was switched to daptomycin on day 4 because of difficulty achieving therapeutic levels of vancomycin and the development of renal insufficiency. Open heart surgery on day 10 revealed aortic valve and mitral valve vegetations with destruction, left ventricular outflow tract (LVOT) septal abscess and ventricular septal defect (VSD). Bio-prosthetic aortic and mitral valve replacement, LVOT and VSD repair were done. Intraoperative cultures grew Staphylococcus lugdunensis. The patient was discharged home with daptomycin to complete 6 weeks of treatment. S. lugdunensis can cause rapidly progressive endocarditis with valve and septal destruction. Early diagnosis and therapy are essential, with consideration of valve replacement.http://www.sciencedirect.com/science/article/pii/S2214250916301184Staphylococcus aureusS. aureusStaphylococcus lugdunensisS. lugdunensisLugdunensisInfective endocarditis |
| spellingShingle | Celestine Ishiekwene Monica Ghitan Margaret Kuhn-Basti Edward Chapnick Yu Shia Lin Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves IDCases Staphylococcus aureus S. aureus Staphylococcus lugdunensis S. lugdunensis Lugdunensis Infective endocarditis |
| title | Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves |
| title_full | Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves |
| title_fullStr | Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves |
| title_full_unstemmed | Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves |
| title_short | Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves |
| title_sort | staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves |
| topic | Staphylococcus aureus S. aureus Staphylococcus lugdunensis S. lugdunensis Lugdunensis Infective endocarditis |
| url | http://www.sciencedirect.com/science/article/pii/S2214250916301184 |
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