Actinomyces naeslundii: An Uncommon Cause of Endocarditis

Abstract

Actinomyces rarely causes endocarditis with 25 well-described cases reported in the literature in the past 75 years. We present a case of prosthetic valve endocarditis (PVE) caused by Actinomyces naeslundii. To our knowledge, this is the first report in the literature of endocarditis due to this organism and the second report of PVE caused by Actinomyces.

Actinomyces neuii: a case report of a rare cause of acute infective endocarditis and literature review

“…Dental cleaningActinomyces naeslundiiClinicalCeftriaxoneArrhythmia. Septic shockDiedCortes [27]2015F512 monthsPAVProsthetics. Dental implantActinomyces naeslundiiClinicalCeftriaxone ➔ ertapenem ➔ amoxicillinRoth spots.SurvivedToom [28]2018F558 monthsMV, AVHOCM with LVOT obstructionActinomyces israeliiClinicalPCNSevere hemolytic anemiaSurvived M male, F female, MV mitral valve, AV aortic valve, TV tricuspid valve, EV Eustachian valve, an embryologic remnant of the valve of the inferior vena cava, PAV prosthetic aortic valve, NA not available, PCN penicillin, CHF congestive heart failure, IVDU intravenous drug use, HOCM hypertrophic obstructive cardiomyopathy, LVOT left ventricular outflow tract…”

“…Five of eight patients reported before 1990 died and five had embolic events (brain, spleen, kidneys, small bowel and skin), whereas only two of 14 cases reported after 1990 died, and only one had emboli to skin. Despite temporal courses of a subacute endocarditis, where stigmata of endocarditis are more common, only one report described Roth’s spots [27]. It is unclear whether this was related to virulence factors from Actinomyces spp., or simply the rarity of these complications [33].…”

Clinical features of actinomycosis: A 20-year experience of a single institute in Southern China

“…Thoracic actinomycosis, including intrathoracic organs and the thoracic wall, accounts for 15-20% of cases [1]. Actinomyces rarely causes endocarditis but sometimes can be life-threatening [22], and there are just some case reports about this uncommon type of actinomycosis [23]. Thoracic actinomycosis exhibits a pulmonary infiltrate, causing cough and hemoptysis (most common clinical signs), chest wall pain, weight loss, sputum production or draining sinuses from the chest wall and later can be disseminated to the pleura, pericardium or chest wall [24].…”

Extensive surgery in medication‐related osteonecrosis of the jaw for the prevention of infective endocarditis

“…Infection of the oral jaw 13–16 and bacteremia from oral surgery 17,18 are moderate risk factors for IE for VHD. Recently, actinomycetes were reportedly associated with MRONJ 19–23 and IE 15,24–27 . In general, oral commensal bacteria are the cause of MRONJ and IE.…”

“…Recently, actinomycetes were reportedly associated with MRONJ [19][20][21][22][23] and IE. 15,[24][25][26][27] In general, oral commensal bacteria are the cause of MRONJ and IE. Therefore, in this case, In addition, prosthetic valve replacement is a high-risk factor for IE.…”