Document Detail


Gonococcal endocarditis: a case report and review of the literature.
MedLine Citation:
PMID:  24163221     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
A 59-year-old Caucasian male presented with progressive dyspnea, arthralgias and fever for three days. A diastolic regurgitation murmur was detected in the aortic area. A transesophageal echocardiograph showed several vegetations and severe aortic regurgitation. Blood cultures yielded Neisseria gonorrhoeae beta-lactamase negative. The patient had not noticed any urogenital discomfort or urethral discharge. The patient successfully underwent surgery for septal abscess debridement. The patient received ceftriaxone 2 g bid for eight weeks and the clinical follow-up was uneventful. The review of the literature revealed a total of the 38 additional cases reported between 1980 and the present. The majority of the patients were young, male and with native valve involvement. There has been a clear tendency for left-sided valve involvement (especially in the aortic valve). All valve cultures were reported negative despite, in most cases, the marked tissue destruction. Polymerase chain reaction was performed in two patients and positive results were shown in both. Cultures of exudates from other locations were negative in most cases. One striking fact is the high proportion of patients who underwent surgery (72 %). Information regarding antibiotic sensitivity was available in 28 cases, with penicillin resistance reported in six patients (21 %) and intermediate sensitivity in four patients (14 %). Resistance to ciprofloxacin was reported in two cases (7 %). A rapid increase and distribution of isolates resistant to third generation cephalosporins have been recently detected. The mortality is high, particularly taking into account that most were young patients who had not presented previous heart disease.
Authors:
Antonio Ramos; Pablo García-Pavía; Beatriz Orden; Marta Cobo; Margarita Sánchez-Castilla; Isabel Sánchez-Romero; Elena Múñez; Mercedes Marín; Carlos García-Montero
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-27
Journal Detail:
Title:  Infection     Volume:  -     ISSN:  1439-0973     ISO Abbreviation:  Infection     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365307     Medline TA:  Infection     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Internal Medicine (Infectious Diseases Unit), Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Maestro Rodrigo 2, Majadahonda, 28220, Madrid, Spain, aramos220@gmail.com.
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