Infective Endocarditis
due to Abiotrophia defectiva: A Report of Two Cases
Mitja Lainscak, Tatjana Lejko-Zupanc, Iztok Strumbelj, Ivan Gasparac,
Manica Mueller-Premru, Mateja Pirs
General Hospital Murska Sobota, Murska
Sobota, University Medical Centre Ljubljana, Ljubljana, Regional
Institute for Public Health, Murska Sobota, Institute for Microbiology
and Immunology, Medical Faculty Ljubljana, Ljubljana, Slovenia |
Background and aim of the study: Endocarditis
due to Abiotrophia sp. is rare and often associated with negative blood
cultures. The rates of treatment failure, infection relapse and mortality
are higher than in endocarditis caused by other viridans streptococci.
Methods: A retrospective review of A. defectiva endocarditis
in a patient with prosthetic aortic valve and in a patient with
Marfan syndrome was performed.
Results: A. defectiva, susceptible to penicillin
(MIC 0.064 mg/l and 0.016 mg/l, respectively) was isolated from
blood cultures of both patients. Treatment with penicillin and
gentamicin was started in both patients. Since the first patient
developed a |
macular rash and leukopenia, penicillin was substituted
with ceftriaxone. Both patients responded well to antibiotic treatment,
did not need prosthetic valve insertion or reinsertion, and were without
any sequelae at one year follow up.
Conclusion: Standard treatment of bacterial endocarditis
with penicillin and gentamicin was effective in both patients.
In contrast to previous reports, the present patients had a favorable
outcome on completion of treatment and at one-year follow up.
The Journal of Heart Valve Disease 2005;14:33-36 |