| Staphylococcus lugdunensis endocarditis following lower extremity revascularization. | |
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MedLine Citation:
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PMID: 17215053 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We describe a fatal case of Staphylococcus lugdunensis aortic valve endocarditis that was diagnosed in a 75-year-old man approximately 6 months following a lower extremity by-pass surgery. A relatively indolent clinical course in the early phase following the suspicious exposure may have contributed to a delay in the diagnosis. At the time of presentation the patient had evidence of rapidly progressive congestive heart failure with anasarca, dyspnea and low grade fevers. Blood cultures were positive for coagulase-negative staphylococci and a transthoracic echocardiogram was not clearly suggestive of infective endocarditis. Despite intense medical treatment the patient expired on day four of hospitalization. On post-mortem examination, multiple vegetations were observed on the aortic valve and culture identification showed S. lugdunensis. Early detection of coagulase-negative bacteremia from multiple blood culture samples in this clinical setting is critical and should give rise to a suspicion of this rare but often fatal form of infective endocarditis. Besides appropriate antibiotic treatment, early surgical referral for valve replacement should be considered since it appears to be the only treatment positively affecting survival. Finally, further studies are needed to establish the efficacy of antibiotic prophylaxis in patients undergoing angiograms with a femoral approach. |
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Authors:
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Federico Viganego; Talat M Nazir; Ching Y Lee; Jean-Paul Hafner; Raymond Smith |
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Publication Detail:
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Type: Case Reports; Letter Date: 2007-01-09 |
Journal Detail:
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Title: International journal of cardiology Volume: 116 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-02-16 Completed Date: 2007-04-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: e4-6 Citation Subset: IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Valve / microbiology Arterial Occlusive Diseases / surgery* Endocarditis, Bacterial / diagnosis, microbiology*, therapy Fatal Outcome Femoral Artery / surgery Heart Failure / microbiology Humans Lower Extremity / blood supply, surgery* Male Popliteal Artery / surgery Reperfusion / adverse effects Staphylococcal Infections / diagnosis, microbiology*, therapy Staphylococcus / isolation & purification Vascular Surgical Procedures / adverse effects* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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