Infective endocarditis caused by multidrug-resistant Streptococcus mitis in a combined immunocompromised patient: an autopsy case report

Matsui, Natsuko; Ito, Makoto; Kuramae, Hitoshi; Inukai, Tomomi; Sakai, Akiyoshi; Okugawa, Masaru

doi:10.1007/s10156-012-0465-9

Cited by 23 publications

(14 citation statements)

References 14 publications

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“…Rheumatic carditis is the most serious of the five streptococcal sequelae and presents with a heart murmur as a result of valve deformation 26 . S. sanguinis, S. mitis , and S. gordonii have also been reported to be correlated with endocarditis 27 28 29 . S. gordonii is also involved in septic arthritis 30 .…”

Section: Discussionmentioning

confidence: 99%

Metagenomic sequencing reveals altered metabolic pathways in the oral microbiota of sailors during a long sea voyage

Zheng

Zhang

Liu

et al. 2015

Sci Rep

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Seafaring is a difficult occupation, and sailors face higher health risks than individuals on land. Commensal microbiota participates in the host immune system and metabolism, reflecting the host's health condition. However, the interaction mechanisms between the microbiota and the host's health condition remain unclear. This study reports the influence of long sea voyages on human health by utilising a metagenomic analysis of variation in the microbiota of the buccal mucosa. Paired samples collected before and after a sea-voyage were analysed. After more than 120 days of ocean sailing, the oral microbial diversity of sailors was reduced by approximately 5 fold, and the levels of several pathogens (e.g., Streptococcus pneumonia) increased. Moreover, 69.46% of the identified microbial sequences were unclassified microbiota. Notably, several metabolic pathways were dramatically decreased, including folate biosynthesis, carbohydrate, lipid and amino acid pathways. Clinical examination of the hosts confirmed the identified metabolic changes, as demonstrated by decreased serum levels of haemoglobin and folic acid, a decreased neutrophil-to-lymphocyte ratio, and increased levels of triglycerides, cholesterol and homocysteine, which are consistent with the observed microbial variation. Our study suggests that oral mucosal bacteria may reflect host health conditions and could provide approaches for improving the health of sailors.

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Section: Discussionmentioning

confidence: 99%

Metagenomic sequencing reveals altered metabolic pathways in the oral microbiota of sailors during a long sea voyage

Zheng

Zhang

Liu

et al. 2015

Sci Rep

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“…S. mitis is most commonly implicated in subacute endocarditis but can cause fulminant IE in the setting of immunosuppression as this patient likely had an attenuated immune response after receiving chemotherapy [ 7 , 8 ]. As mentioned above, IE in cancer patients is commonly due to the use of catheters; however, the most common site of VGS in all patients is the gastrointestinal tract [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…This case is the first presentation of ASA syndrome emerging secondary to S. mitis IE in a patient with malignancy [ 7 ]. Patients undergoing chemotherapy should be thoroughly assessed when there is any clinical suspicion for bacteremia or endocarditis given the likelihood of S. mitis infection, which may be resistant to penicillins and fluoroquinolones [ 7 ]. A recent study of pathogens in human breast milk showed that 83.3% of S. mitis isolates were resistant to at least one antibiotic, and of those, half were resistant to three or more antibiotics [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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A Case of Anterior Spinal Artery Syndrome Caused by Streptococcus mitis Endocarditis

Mahtabfar

Eshraghi

DʼSouza

et al. 2018

Case Reports in Medicine

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Background Infectious endocarditis (IE) typically occurs in the setting of intravenous drug use, prosthetic heart valves, or rheumatic heart disease. However, there are a few reports of IE occurring in the setting of immunosuppression secondary to cancer and/or chemotherapy. Here, we present a case of a cancer patient who developed anterior spinal artery (ASA) syndrome secondary to a septic embolus from IE. Case Presentation A 78-year-old male with a history of gastroesophageal cancer treated with chemotherapy and radiation presented to the hospital after a fall at home. He reported experiencing dyspnea and orthopnea for two weeks prior to presentation. In the ED, his vital signs were stable, and his examination was significant for a flaccid paralysis of the right lower extremity. Diagnosis of septic emboli secondary to IE was made after the echocardiogram showed the presence of vegetations on the aortic valve, blood cultures were positive for Streptococcus mitis, and thoracic spine MRI was indicative of an infarction at T10. Discussion This case highlights the presence of IE in the setting of cancer and chemotherapy. Although cancer is a rare cause of IE, clinicians must maintain a high index of suspicion in order to minimize the sequelae of IE.

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“…Клинически значимая бактериемия может возникать при распаде опухолей, вследствие повышения проницаемости слизистых оболочек и снижения иммунитета, особенно в случаях химиотерапии и лучевой терапии c нейтропенией; при инвазивных и эндоскопических медицинских процедурах, которые часто проводят при опухолевых заболеваниях [23,47,53]. При онкологических заболеваниях в зависимости от «входных ворот» инфекции и клинической ситуации наблюдается бактериемия как с типичными для ИЭ возбудителями (S. mitis, S. galolyticus, другие стрептококки группы D, энтерококки, Staphylococcus aureus), так и с редкими для ИЭ микроорганизмами, как, например, Lomentospora prolificans [15,28,43,48,[54][55][56][57][58][59][60]. Лучшая модель, иллюстрирующая эту гипотезу, как уже было отмечено выше, -ИЭ, вызванный S. gallolytocus, у больных с опухолями кишечника.…”

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Infective Endocarditis and Malignant Neoplasms: Facts and Hypotheses

Чипигина¹,

Карпова²,

Барсегян³

et al. 2018

Klinicist

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The problem of the association of infective endocarditis (IE) and oncological diseases has been discussed for more than 60 years, and is now becoming increasingly relevant because of observed increasing of number IE in elderly patients. The review of the literature presents both data on the incidence of oncological diseases diagnosed with IE and in the long-term follow-up of patients after IE, as well as current estimates of IE incidence in cancer patients, obtained in large population-based studies. The highest risk of IE development was found in patients with tumors of the colon and rectum, and the predominant etiological role of Streptococcus bovis/gallolyticus was proved in such cases. The frequency of concomitant oncological diseases is higher in elderly patients with IE. On the other hand, it is obvious that IE can be considered as a marker of latent oncological pathology, especially gastrointestinal tumors, malignant blood diseases and lymphoproliferative diseases that are most often detected during the period of active IE and in the first 1–2 years later. Therefore, mandatory colonoscopy is recommended for patients with IE caused by Streptococcus bovis/gallolyticus during the period of IE and annually in subsequent years, even if initially the colonoscopy did not reveal pathology. In elderly IE patients we should also be aware of the high likelihood of concomitant oncological pathology and carry out appropriate oncological search. Antimicrobial prophylaxis of IE in patients with gastrointestinal cancer remains unresolved.

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Infective endocarditis caused by multidrug-resistant Streptococcus mitis in a combined immunocompromised patient: an autopsy case report

Cited by 23 publications

References 14 publications

Metagenomic sequencing reveals altered metabolic pathways in the oral microbiota of sailors during a long sea voyage

Metagenomic sequencing reveals altered metabolic pathways in the oral microbiota of sailors during a long sea voyage

A Case of Anterior Spinal Artery Syndrome Caused by Streptococcus mitis Endocarditis

Infective Endocarditis and Malignant Neoplasms: Facts and Hypotheses

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