Infective endocarditis and Sjögren’s syndrome diagnosed simultaneously

Abstract

Poor dentition and/or dental infection due to insufficient oral care are presumed to be risk factors for infective endocarditis (IE). We present a case of endocarditis caused by Granulicatella adiacens and Sjögren’s syndrome (SS) with oral complications diagnosed simultaneously.A 67-year-old woman was admitted to our hospital with fever, general fatigue, arthralgia, and back pain. She was diagnosed with primary SS according to the criteria of the American-European Consensus Group. Transthoracic echocardiography carried out to examine her persistent fever revealed vegetation formation (14 × 5 mm) on the aortic valve and her blood cultures were positive for G. adiacens. According to modified Duke’s criteria, she was also diagnosed with IE. She underwent aortic valve replacement and was administered ampicillin with gentamicin for 6 weeks following surgery.G. adiacens, which is formerly known as one of the nutritionally variant streptococci, is found as part of the normal microbiota of the oral cavity. The patient had chronic periodontitis associated with SS that likely predisposed to G. adiacens bacteremia and subsequent seeding of the aortic valve. Patients with SS may be at risk of IE because of the increased risk of bacteremia from oral complications such as dental caries or periodontal disease.An association between SS and IE has not yet been reported. Our case indicates that SS may be the underlying pathology in patients with IE due to an oral bacterium.

Granulicatella adiacens as an Unusual Cause of Empyema: A Case Report and Review of Literature

“…Using the inclusion and exclusion criteria, 24 literature were found relevant and included in the review. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Clinical details of all published literature are compiled in the Table 1 . As per the review of literature of last 10 years, G. adiacens is found to be the cause of various infections such as bacteremia, endocarditis, osteomyelitis, septic arthritis, discitis, prosthetic joint infections, carbuncle, bacterascites (spontaneous bacterial peritonitis), dacryocystitis, and abscess.…”

Granulicatella adiacens Infective Endocarditis Treated With Teicoplanin and Ceftriaxone: A Case Report

“…Approximately 5% of bacterial endocarditis cases are caused by the opportunistic pathogen G. adiacens. 1 Its fastidious nature of growth and increased resistance to betalactam and macrolide antibiotics have contributed to problems in treatment. 2 In terms of risk factors, pre-existing cardiac pathology, neutropenia, and prior dental manipulations in the past 6 months are frequent risk factors in IE caused by Granulicatella.…”

“…IE is a relatively uncommon but life-threatening disease of the endocardium. Approximately 5% of bacterial endocarditis cases are caused by the opportunistic pathogen G. adiacens 1 . Its fastidious nature of growth and increased resistance to beta-lactam and macrolide antibiotics have contributed to problems in treatment 2 …”

“…Granulicatella adiacens, a Gram-positive facultative anaerobe and classified into nutritionally variant streptococci (NVS), is part of the normal microbiota of human gastrointestinal, urogenital, and upper respiratory tracts. 1 Here, we report a unique case of infective endocarditis (IE) caused by G. adiacens in an asplenic patient with active hyperthyroidism and schizophrenia. The definitive diagnosis was made after 4 months of the patient having recurrent fever and he was successfully cured by bacterial eradication using teicoplanin combined with ceftriaxone followed by valve replacement surgery.…”

“…Granulicatella adiacens , a Gram-positive facultative anaerobe and classified into nutritionally variant streptococci (NVS), is part of the normal microbiota of human gastrointestinal, urogenital, and upper respiratory tracts 1 . Here, we report a unique case of infective endocarditis (IE) caused by G. adiacens in an asplenic patient with active hyperthyroidism and schizophrenia.…”