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Endocarditis due to vancomycin-resistant enterococci (E.gallinarum): acasereport

Abstract number: R2142

Ersoz G., Uguz M., Aytacoglu B.N., Kaya A.

The first described vancomycin resistant enterecocci (VRE) was about twenty years ago. Recently many clinics reported VRE. However endocarditis due to VRE is still a rare entity and there are only a few cases reported in the literature.

Case: We report a 59 year-old male patient with chronic renal failure who was on haemodialysis. He presented with a sudden onset of fever, tachycardia and respiratory distress. Echocardiography was performed and vegetation on the mitral valve was found. As he was diagnosed to have endocarditis the patient was put on ampicilin and gentamicin therapy. He underwent an emergent mitral and aortic valve surgery due to heart failure. While he was still on ampicilin and gentamicin therapy, E. gallinarum that was resistant to vancomycin (MIC > 32 mg/L) was isolated from the surgical valve specimens and hence his antibiotic regime was switched to teicoplanin (MIC=0.5 mg/L). 28 days after teicoplanin therapy the patient was discharged with free of symptoms and any complication.

Conclusion: Endocarditis due to vancomycin resistant enterococci is an uncommon clinical situation. In review of the literature the commonly encountered causative agent for endocarditis was found to be E. faecium especially in patients with comorbid conditions. This patient had no prior known valvular disease therefore having no cardiac predisposition but presented with endocarditis caused by E. gallinarum. This patient is presented as an example for a sudden onset endocarditis with an unusual type of enterococci.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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