Gonococcal Infective Endocarditis Returns

Abstract

Disseminated gonococcal infection occurs in 0.5%-3% of gonorrhea cases, usually in the form of either a triad of arthralgia, tenosynovitis, and skin lesions or purulent arthritis. Other rare complications include gonococcal infective endocarditis that occurs in 1%-2% of cases with 99 cases reported in the literature since 1938. Our case presents an additional rare case of aortic valve gonococcal endocarditis requiring surgical intervention and a prolonged antibiotic course, despite the absence of genitourinary symptoms or mucosal evidence of infection. This case was found to have sepsis and gonococcal endocarditis, which was clearly confirmed with positive blood cultures and aortic valve vegetation. It was further complicated by the evidence of splenic embolization and severe aortic regurgitation requiring surgical valve replacement and debridement of an annular perivalvular abscess. A high degree of suspicion is needed to early diagnose these unusual cases of gonococcal endocarditis, especially in sexually active individuals, for its known virulence causing valve destruction and high mortality. Our case represents a valuable addition to the reported cases of this diagnosis and is complemented by a short literature review.

Molecular characterization and antimicrobial resistance of Enterococcus faecalis isolated from seafood samples

“…Additionally, they can easily be adapted to the gastrointestinal tract of their hosts and mainly found in the soil, water, and the environment (Daniel et al, 2017). E. faecalis infections are pri-E. faecalis strains cause serious infections, including gastrointestinal and urinary tract infections, meningitis, bacteraemia, and periodontitis (Abat et al, 2016;Ma et al, 2021;Prajsnar et al, 2013;Said et al, 2021). The severity and pathogenicity of diseases caused by these bacteria are higher in the presence of well-defined virulence factors and toxins (Goh et al, 2017;Wu et al, 2020).…”

“…E. faecalis strains cause serious infections, including gastrointestinal and urinary tract infections, meningitis, bacteraemia, and periodontitis (Abat et al., 2016; Ma et al., 2021; Prajsnar et al., 2013; Said et al., 2021). The severity and pathogenicity of diseases caused by these bacteria are higher in the presence of well‐defined virulence factors and toxins (Goh et al., 2017; Wu et al., 2020).…”

Defibrillator-associated gonococcal endocarditis

“…Neisseria gonorrhea endocarditis is a rare complication of DGI and represents less than 0.1% of such cases. 1 , 2 , 3 Although CIED pocket infection has been reported in DGI, 4 to our knowledge this is the first report of CIED-associated gonococcal endocarditis. Acute and subacute CIED infections are typically attributed to coagulase-negative Staphylococcus, whereas chronic infections are largely caused by S. aureus (50%) and coagulase-negative staphylococci (50%) in more than 95% of cases.…”

Penicillin-resistant gonorrheal endocarditis presenting with large annular abscess and aortic valve destruction

“…Gonococcal endocarditis is known to be aggressive and frequently presents with valvular vegetations, valve destruction and paravalvular abscess [ 9 ]. The aortic valve is most commonly involved (50%) followed by mitral (24.2%) and then pulmonary valve (14.3%).…”