Endocarditis caused byNeisseria elongata subspeciesnitroreducens: Case report and literature review

Abstract

Neisseria elongata subsp. nitroreducens, an usual commensal of the nasopharynx, can cause serious infections, usually endocarditis. A case of Neisseria elongata endocarditis complicating mitral valve prolapse in a patient allergic to penicillin is reported. Cure was obtained with a combination of ceftriaxone and gentamicin, there being no requirement for surgery during the acute phase of the disease.

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.…”

“…elongata are given in [4,6]. It is n o t e w o r t h y that 27% of the 95 strains received at the C D C , which c a m e f r o m a variety of h u m a n sources, were f r o m blood [3], and the authors n o t e d that the main feature of septicemia caused by N. elongata ssp.…”

Infective Endocarditis Caused by Neisseria elongata on a Native Tricuspid Valve and Confirmed by DNA Sequencing

“…A few cases of IE caused by N. elongata subsp nitroreducens have been described. 2,8,9 In 1990, on the basis of biochemical and DNA studies, the Centers for Disease Control reported on the analysis of 95 strains that belonged to the genus Neisseria and recognized that N. elongata subsp nitroreducens was an important pathogen of the genus Neisseria and was responsible for significant infections, such as septicemia, in human beings. In recent decades, the chief designation of this organism as a cause of IE-induced septicemia has been non-gonococcal, non-meningococcal Neisseriae.…”