Among 240 military personnel evaluated after presenting with postdeployment exertional dyspnea, a combination of symptoms, auscultatory findings, imaging, and visualization of the airways by bronchoscopy identified six individuals with excessive dynamic central airway collapse as the sole apparent cause of dyspnea. Exercise-associated excessive dynamic airway collapse should be considered in the differential diagnosis of exertional dyspnea.
Gemella morbillorum is a gram positive cocci, considered normal flora of the upper respiratory tract, gastrointestinal tract, and genitourinary tract in humans. As a pathogen, there are reported cases of infectious endocarditis, bacteremia, sepsis, and abscesses, primarily associated with dental instrumentation, prosthetic heart valves, colon cancer, and endovascular access. We report a case of an 87-year-old Caucasian male with a history of a ruptured chordae of the anterior mitral leaflet, severe mitral regurgitation (MR), and atrial fibrillation who developed multisystem organ failure due to Gemella morbillorum native valve endocarditis without any precipitating factor. He was diagnosed per Duke criteria, treated with intravenous fluids, packed red blood cell transfusion, and broad spectrum antibiotics, with improvement in his clinical course. Our patient survived despite his generalized poor health, where he was eventually discharged to a skilled nursing facility.
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