Centers for Disease Control Group M-6: A Cause of Destructive Endocarditis

Endocarditis Due toNeisseria elongataSubspeciesnitroreducens: Case Report and Review

“…It is of interest that five patients had identified; however, including ours, only 11 cases (four females and seven males) met the Duke criteria (table 1). Including our progressive disease while receiving appropriate antibiotic therapy and required valve replacement [1,[4][5][6][7]. Despite its severity, no patient, there were seven cases of definite infective endocarditis [1,[4][5][6][7] and four cases of possible infective endocarditis [3, 8-deaths associated with this illness have been reported.…”

Bioprosthetic valve endocarditis caused byNeisseria elongata subspeciesnitroreducens

“…nitroreducens appears uniformly susceptible to most antibiotics including ampicillin [1]. T h e course of the endocarditis was always favourable in patients on antibiotic therapy, eventually followed by valve replacement [4,8]. Antibiotic therapy with gentamicin for 14 days and ampicillin for 6 weeks also cured the endocarditis of our patient without serious cardiac valve damage.…”

“…O f these 12 bacteremic strains, nine (75 % ) were associated with the clinical diagnosis of endocarditis. T o our knowledge, only seven other cases have b e e n described in detail in the English literature [3,4,[7][8][9]11]. W h e n blood cultures are positive for N. elongata, endocarditis should be sought systematically.…”

Neisseria elongataendocarditis of a native aortic valve

“…According to the European Society of Cardiology guidelines, a transoesophageal echocardiogram should be a part of the initial assessment of these patients in order to provide a thorough surgical evaluation and to assess the extent of infection, size of vegetation and any valvular dysfunction 27. In addition, it is evident that the aortic and mitral valves are the most common valves affected by N. elongata with 11 cases documenting involvement of the mitral valve2–4 7 17 19 21–24 and 10 cases of the aortic valve 8 11 12 16 18 20 24–26. On the basis of the aggressive nature of this organism, we suggest that clinicians should consider extended antibiotic treatment and early surgical evaluation.…”