Lactobacillus Endocarditis Necessitating Combined Mitral and Aortic Valve Replacement—A Case Report

Olearchyk, Andrew S.

doi:10.1177/153857449302700310

Vascular Surgery

1993

DOI: 10.1177/153857449302700310

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Lactobacillus Endocarditis Necessitating Combined Mitral and Aortic Valve Replacement—A Case Report

Andrew S. Olearchyk¹

Abstract: A sixty-nine-year-old man with previous exposure to radiation and with Heyde's syndrome developed endocarditis caused by Lactobacillus acidophilus, involving the mitral and aortic valves, and resistant to antibiotic treatment.He underwent mitral and aortic valve replacement (MVR and AVR) with mechanical valves, followed by six weeks of antibiotic therapy with excellent results.

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2024

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Cited by 2 publications

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Heyde’s syndrome: a systematic review of case reports

Saha

Wien

Fancher

et al. 2022

BMJ Open Gastroenterol

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ObjectiveHeyde’s syndrome (HS), a rare condition characterised by a unique relationship between severe aortic stenosis and angiodysplasia, is often diagnosed late increasing the risk for a prolonged hospital course and mortality in the elderly. The leading hypothesis explaining the aetiology of HS is acquired von Willebrand syndrome (AVWS) but not all studies support this claim. While individual cases of HS have been reported, here we present the first systematic review of case reports and focus on the prevalence of AVWS.DesignA systematic search was conducted through PubMed/MEDLINE, CINAHL-EBSCO, Web of Science and Google Scholar since inception. The resulting articles were screened by two independent reviewers based on inclusion criteria that the article must be a case report/series or a letter to the editor in English describing HS in an adult patient.ResultsSeventy-four articles encompassing 77 cases met the inclusion criteria. The average age was 74.3±9.3 years old with a slight female predominance. The small intestine, especially the jejunum, was the most common location for bleeding origin. Capsule endoscopy and double balloon enteroscopy were superior at identifying bleeding sources than colonoscopy (p=0.0027 and p=0.0095, respectively) and oesophagogastroduodenoscopy (p=0.0006 and p=0.0036, respectively). The mean duration from symptom onset to diagnosis/treatment of HS was 23.8±39 months. Only 27/77 cases provided evidence for AVWS. Surgical and transcutaneous aortic valve replacement (AVR) were superior at preventing rebleeding than non-AVR modalities (p<0.0001).ConclusionFurther research is warranted for a stronger understanding and increased awareness of HS, which may hasten diagnosis and optimal management.

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Heyde’s syndrome: a systematic review of case reports

Saha

Wien

Fancher

et al. 2022

BMJ Open Gastroenterol

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Infective Endocarditis by Lactobacillus Species—A Narrative Review

Ioannou,

Ziogou,

Giannakodimos

et al. 2024

Antibiotics

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Bacteria of the genus Lactobacillus are microaerophilic or aerotolerant anaerobic Gram-positive non-spore-forming rods. They are considered essential members of the human gut microbiome; however, recent studies have revealed that these microorganisms are less predominant in the gut microbiome than initially thought. Lactobacillus spp. is mainly known for its use as a probiotic in foods and supplements to prevent and treat specific issues such as infectious diseases, irritable bowel syndrome, and diabetes mellitus. However, Lactobacillus spp. may occasionally cause infections such as bacteremia or infective endocarditis (IE). The present study aimed to review all cases of IE by Lactobacillus spp. and describe the epidemiology, microbiology, clinical characteristics, treatment, and outcomes of this infection by collecting relevant data from studies existing in Pubmed and Scopus until 28 September 2023. A total of 77 studies containing data for 82 patients were included. The median age was 56 years, and 69.6% were male. A prosthetic valve was present in 16% of patients, and 17.3% had previously been on probiotics. The aortic valve was the most commonly involved intracardiac site, followed by the mitral valve. Fever, embolic phenomena, sepsis, and heart failure were the most common clinical presentations. Aminoglycosides and penicillin were the most commonly used antimicrobials for definitive treatment. Surgery was performed in 53.7% of patients. Overall mortality was 17.1%. IE in prosthetic valves and presentation with shock were independently associated with overall mortality.

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Lactobacillus Endocarditis Necessitating Combined Mitral and Aortic Valve Replacement—A Case Report

Cited by 2 publications

References 7 publications

Heyde’s syndrome: a systematic review of case reports

Heyde’s syndrome: a systematic review of case reports

Infective Endocarditis by Lactobacillus Species—A Narrative Review

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