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

Abstract

Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies.

Native Mitral Valve Endocarditis Caused byNeisseria elongatasubsp.nitroreducensin a Patient with Marfan Syndrome: First Case in Italy and Review of the Literature

“…Hence, we speculate that NE entered the bloodstream during unrecognized oral events, such as daily dental care. Cases originating from a skin infection have also been reported [ 15 ]. The culprit organism has been confirmed by mass spectrometry directly from the positive blood culture, as previously reported.…”

Microbial characteristics across different tongue coating types in a healthy population

“…Within the biomarker of the Y-thin tongue coating type, the genus Moraxella and species Neisseria elongate are common bacterial microbiota of the oropharynx. Moraxella sometimes gives rise to opportunistic infections [20], and numerous reports indicate endocarditis [21,22], osteomyelitis [23] and pancreatic cancer [13] induced by Neisseria elongata, typically arising after dental procedures or dental abscesses. In Firmicutes, the species G. sanguinis was again an opportunistic pathogen leading to endocarditis [24], and the family Peptostreptococcaceae was found to be overrepresented in the guts of colorectal cancer patients [25].…”

Neisseria elongatasubspelongatainfective endocarditis following endurance exercise

“…One case study has also suggested that N. elongata subsp nitroreducens IE can originate from skin infections 14. In this case, we were unable to identify any traditional risk factors for the development of IE.…”