Bioprosthetic valve endocarditis caused byNeisseria elongata subspeciesnitroreducens

Abstract

A new case of Neisseria elongata ssp. nitroreducens bacteremia and endocarditis in a 74-year-old woman who had undergone aortic valve replacement in 1992 is reported in detail. N. elongata ssp. nitroreducens differs from the other subspecies of N. elongata in the additional reduction of nitrate without gas formation. Like most Neisseria spp. except Neisseria meningitidis and Neisseria gonorrhoeae, this N. elongata ssp. nitroreducens is usually classified in the group of "non-pathogenic" Neisseria spp. This case report indicates that the presence of subspecies of this group is significant when isolated from normally sterile sites and can cause severe disease in susceptible individuals.

Native Mitral Valve Endocarditis Caused byNeisseria elongatasubsp.nitroreducensin a Patient with Marfan Syndrome: First Case in Italy and Review of the Literature

“…To the best of our knowledge, more than 20 cases of NE endocarditis have appeared in the literature, of which 18, including the present case, fulfilled the modified Dukes criteria for a definite diagnosis of infective endocarditis [ 5 ]. Preexisting heart diseases (valvular or congenital heart disease) are considered as risk factors for N. elongata endocarditis [ 6 – 8 ]. However, some cases have also been occasionally reported in patients without previous apparent cardiac disease [ 9 ].…”

Endocarditis Due to Rare and Fastidious Bacteria

“…In the literature, 27 cases of N. elongata subsp. nitroreducens have been reported (62,185,300). Endocarditis occurs in young middle-aged adults with a mean age of 39 years, preexisting valve conditions that predispose to infection include prosthetic valves (80% of patients) and previous dental procedures (20% of patients).…”

Prosthetic valve endocarditis due to Neisseria elongata subsp. elongata in a patient with Klinefelter's syndrome

“…We have reviewed the English-language reports of endocarditis due to all the subspecies of N. elongata. Eighteen cases of endocarditis due to N. elongata (including this case) have been described in detail (Andersen et al, 1995;Apisarnthanarak et al, 2001;Dominguez & Smith, 1998;Grant et al, 1990;Haddow et al, 2003;Hoshino et al, 2005;Imperial et al, 1995;Kaplan & Flaherty, 1991;Kociuba et al, 1993;Meuleman et al, 1996;Nawaz et al, 1996;Perez, 1986;Picu et al, 2003;Rose et al, 1990;Simor & Salit, 1983;Struillou et al, 1993). The reported age range is 7-82 years.…”