Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature

Lactococcus garvieae is an unusual cause of infective endocarditis (IE). No current diagnostic and therapeutic guidelines are available to treat IE caused by these organisms. Based on a case report, we provide a review of the literature of IE caused by L. garvieae and highlight diagnostic and treatm...

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Autores:
Malek, Alexandre
De la Hoz, Alejandro
Gómez-Villegas, Sara Isabel
Nowbakht, Cima
Arias, César A.
Tipo de recurso:
Fecha de publicación:
2019
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
eng
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/1561
Acceso en línea:
http://hdl.handle.net/20.500.12495/1561
https://doi.org/10.1186/s12879-019-3912-8
Palabra clave:
Bacterias grampositivas
Endocarditis
Infecciones cardiovasculares
Cardiopatías
Lactococcus
Case report
Gram positive cocci
Infective endocarditis
Rights
License
Attribution 4.0 International
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dc.title.spa.fl_str_mv Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
title Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
spellingShingle Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
Bacterias grampositivas
Endocarditis
Infecciones cardiovasculares
Cardiopatías
Lactococcus
Case report
Gram positive cocci
Infective endocarditis
title_short Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
title_full Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
title_fullStr Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
title_full_unstemmed Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
title_sort Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature
dc.creator.fl_str_mv Malek, Alexandre
De la Hoz, Alejandro
Gómez-Villegas, Sara Isabel
Nowbakht, Cima
Arias, César A.
dc.contributor.author.none.fl_str_mv Malek, Alexandre
De la Hoz, Alejandro
Gómez-Villegas, Sara Isabel
Nowbakht, Cima
Arias, César A.
dc.subject.decs.spa.fl_str_mv Bacterias grampositivas
Endocarditis
Infecciones cardiovasculares
Cardiopatías
topic Bacterias grampositivas
Endocarditis
Infecciones cardiovasculares
Cardiopatías
Lactococcus
Case report
Gram positive cocci
Infective endocarditis
dc.subject.keywords.spa.fl_str_mv Lactococcus
Case report
Gram positive cocci
Infective endocarditis
description Lactococcus garvieae is an unusual cause of infective endocarditis (IE). No current diagnostic and therapeutic guidelines are available to treat IE caused by these organisms. Based on a case report, we provide a review of the literature of IE caused by L. garvieae and highlight diagnostic and treatment challenges of these infections and implications for management. A 50-year-old Asian male with mitral prosthetic valve presented to the hospital with intracranial haemorrhage, which was successfully treated. Three weeks later, he complained of generalized malaise. Further work up revealed blood cultures positive for Gram-positive cocci identified as L. garvieae by MALDI-TOF. An echocardiogram confirmed the diagnosis of IE. Susceptibility testing showed resistance only to clindamycin. Vancomycin plus gentamicin were started as empirical therapy and, subsequently, the combination of ceftriaxone plus gentamicin was used after susceptibility studies were available. After two weeks of combination therapy, ceftriaxone was continued as monotherapy for six additional weeks with good outcome. Twenty-five cases of IE by Lactococcus garvieae have been reported in the literature. Compared to other Gram-positive cocci, L. garvieae affects more frequently patients with prosthetic valves. IE presents in a subacute manner and the case fatality rate can be as high as 16%, comparable to that of streptococcal IE (15.7%). Reliable methods for identification of L. garvieae include MALDI-TOF, 16S RNA PCR, API 32 strep kit and BD Automated Phoenix System. Recommended antimicrobials for L. garvieae IE are ampicillin, amoxicillin, ceftriaxone or vancomycin in monotherapy or in combination with gentamicin.
publishDate 2019
dc.date.accessioned.none.fl_str_mv 2019-07-24T15:10:22Z
dc.date.available.none.fl_str_mv 2019-07-24T15:10:22Z
dc.date.issued.none.fl_str_mv 2019
dc.type.spa.fl_str_mv article
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dc.type.local.spa.fl_str_mv artículo
dc.identifier.issn.none.fl_str_mv 1471-2334
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12495/1561
dc.identifier.doi.none.fl_str_mv https://doi.org/10.1186/s12879-019-3912-8
dc.identifier.instname.spa.fl_str_mv instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad El Bosque
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identifier_str_mv 1471-2334
instname:Universidad El Bosque
reponame:Repositorio Institucional Universidad El Bosque
repourl:https://repositorio.unbosque.edu.co
url http://hdl.handle.net/20.500.12495/1561
https://doi.org/10.1186/s12879-019-3912-8
dc.language.iso.none.fl_str_mv eng
language eng
dc.relation.ispartofseries.spa.fl_str_mv BMC Infectious Diseases, 1471-2334, Vol. 19, 2019, p. 10
dc.relation.uri.none.fl_str_mv https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3912-8
dc.rights.*.fl_str_mv Attribution 4.0 International
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by/4.0/
dc.rights.local.spa.fl_str_mv Acceso abierto
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dc.rights.creativecommons.none.fl_str_mv 2019
rights_invalid_str_mv Attribution 4.0 International
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http://purl.org/coar/access_right/c_abf2
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dc.publisher.spa.fl_str_mv Biomed Central
dc.publisher.journal.spa.fl_str_mv BMC Infectious Diseases
institution Universidad El Bosque
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spelling Malek, AlexandreDe la Hoz, AlejandroGómez-Villegas, Sara IsabelNowbakht, CimaArias, César A.2019-07-24T15:10:22Z2019-07-24T15:10:22Z20191471-2334http://hdl.handle.net/20.500.12495/1561https://doi.org/10.1186/s12879-019-3912-8instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coapplication/pdfengBiomed CentralBMC Infectious DiseasesBMC Infectious Diseases, 1471-2334, Vol. 19, 2019, p. 10https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3912-8Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Acceso abiertohttp://purl.org/coar/access_right/c_abf4392019http://purl.org/coar/access_right/c_abf2Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literaturearticleartículohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501Bacterias grampositivasEndocarditisInfecciones cardiovascularesCardiopatíasLactococcusCase reportGram positive cocciInfective endocarditisLactococcus garvieae is an unusual cause of infective endocarditis (IE). No current diagnostic and therapeutic guidelines are available to treat IE caused by these organisms. Based on a case report, we provide a review of the literature of IE caused by L. garvieae and highlight diagnostic and treatment challenges of these infections and implications for management. A 50-year-old Asian male with mitral prosthetic valve presented to the hospital with intracranial haemorrhage, which was successfully treated. Three weeks later, he complained of generalized malaise. Further work up revealed blood cultures positive for Gram-positive cocci identified as L. garvieae by MALDI-TOF. An echocardiogram confirmed the diagnosis of IE. Susceptibility testing showed resistance only to clindamycin. Vancomycin plus gentamicin were started as empirical therapy and, subsequently, the combination of ceftriaxone plus gentamicin was used after susceptibility studies were available. After two weeks of combination therapy, ceftriaxone was continued as monotherapy for six additional weeks with good outcome. Twenty-five cases of IE by Lactococcus garvieae have been reported in the literature. Compared to other Gram-positive cocci, L. garvieae affects more frequently patients with prosthetic valves. IE presents in a subacute manner and the case fatality rate can be as high as 16%, comparable to that of streptococcal IE (15.7%). Reliable methods for identification of L. garvieae include MALDI-TOF, 16S RNA PCR, API 32 strep kit and BD Automated Phoenix System. 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