Multi-valvular infective endocarditis from<i>Gemella morbillorum</i>

Desai, Amishi; Bonura, Erin

doi:10.1136/bcr-2021-242093

Cited by 4 publications

(2 citation statements)

References 44 publications

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“…The management of endocarditis due to Gemella species posed several challenges. Empirical antibiotic regimens typically included broad-spectrum agents such as penicillin and gentamicin followed by tailored regimens based on susceptibility testing and clinical response [4,45,48,53]. The review highlighted the increasing prevalence of antimicrobial resistance among Gemella isolates, underscoring the importance of judicious antibiotic use and the potential need for combination therapy or alternative treatment strategies.…”

Section: Discussionmentioning

confidence: 99%

An Emerging Threat: A Systematic Review of Endocarditis Caused by Gemella Species

Gonzalez,

Franco,

Sinha

et al. 2024

Cureus

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Infective endocarditis caused by Gemella species is increasingly recognized as an emerging clinical entity. Gemella species are fastidious gram-positive cocci that are typically commensal organisms but can become opportunistic pathogens. This systematic review aimed to provide a comprehensive overview of endocarditis due to Gemella species by synthesizing existing evidence. A total of 52 case reports were identified through a rigorous search and selection process. The most prevalent causative species were G. morbillorum (46.3%) and G. haemolysans (25.9%), with a striking male predominance (79.6%). The clinical presentation was largely nonspecific, mirroring typical infective endocarditis. However, the indolent nature of the illness and fastidious growth requirements of Gemella species often led to diagnostic delays. Echocardiography, particularly transesophageal echocardiography, played a crucial role in the diagnosis, enabling the detection of valvular vegetation and the assessment of complications. Management posed significant challenges, including the need for broad-spectrum empirical antibiotic therapy and increasing antimicrobial resistance among Gemella isolates. Surgical intervention was frequently required for severe valvular dysfunction, persistent infection, or embolic complications. Despite advances in diagnosis and treatment, endocarditis due to Gemella species remains associated with significant morbidity and mortality, underscoring the importance of early recognition and multidisciplinary management. This review highlights the emerging clinical significance of Gemella species as causative agents of infective endocarditis and identifies areas for further research.

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Section: Discussionmentioning

confidence: 99%

An Emerging Threat: A Systematic Review of Endocarditis Caused by Gemella Species

Gonzalez,

Franco,

Sinha

et al. 2024

Cureus

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“…Over the years, there has been a shift in the leading cause of IE from Streptococcus spp., commonly attributed to dental procedures in the past, to Staphylococcus aureus [ 7 ]. While G. morbillorum , a subspecies of viridans streptococci, is a known cause of endocarditis, its incidence in the literature is rare, with less than 40 documented cases [ 8 ]. Endocarditis can involve multiple heart valves, as evidenced by two case reports that documented multivalvular involvement of three valves.…”

Section: Discussionmentioning

confidence: 99%

We Found a Gem in Your Heart: Valvular Heart Disease and Infective Endocarditis Discovered

Lim,

Barimayena,

Mita

et al. 2023

Cureus

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Valvular heart disease (VHD) occurs when there is a functional impairment in the valvular apparatus that either obstructs or regurgitates the backflow of blood. When a microorganism resides in those valves, it injures the leaflets and causes complications such as thromboembolic events. Infective endocarditis (IE), usually caused by the Staphylococci and Streptococcus group, is a disease that occurs on the heart valves. Antibiotic resistance is common; thus, culture and sensitivity testing should be done for a more targeted treatment approach. We herein present a rare case of Gemella morbillorum (G. morbillorum) vegetations found in a patient's heart that initially presented with cerebrovascular disease symptoms and underwent heart surgery in the end.

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Metagenomic Study of the MESA: Detection of Gemella Morbillorum and Association With Coronary Heart Disease

Taylor,

Wood,

Rotter

et al. 2024

JAHA

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Background Inflammation is a feature of coronary heart disease (CHD), but the role of proinflammatory microbial infection in CHD remains understudied. Methods and Results CHD was defined in the MESA (Multi‐Ethnic Study of Atherosclerosis) as myocardial infarction (251 participants), resuscitated arrest (2 participants), and CHD death (80 participants). We analyzed sequencing reads from 4421 MESA participants in the National Heart, Lung, and Blood Institute Trans‐Omics for Precision Medicine program using the PathSeq workflow of the Genome Analysis Tool Kit and a 65‐gigabase microbial reference. Paired reads aligning to 840 microbes were detected in >1% of participants. The association of the presence of microbe reads with incident CHD (follow‐up, ~18 years) was examined. First, important variables were ascertained using a single regularized Cox proportional hazard model, examining change of risk as a function of presence of microbe with age, sex, education level, Life's Simple 7, and inflammation. For variables of importance, the hazard ratio (HR) was estimated in separate (unregularized) Cox proportional hazard models including the same covariates (significance threshold Bonferroni corrected P <6×10 −5 , 0.05/840). Reads from 2 microbes were significantly associated with CHD: Gemella morbillorum (HR, 3.14 [95% CI, 1.92–5.12]; P =4.86×10 −6 ) and Pseudomonas species NFACC19‐2 (HR, 3.22 [95% CI, 2.03–5.41]; P =1.58×10 −6 ). Conclusions Metagenomics of whole‐genome sequence reads opens a possible frontier for detection of pathogens for chronic diseases. The association of G morbillorum and Pseudomonas species reads with CHD raises the possibilities that microbes may drive atherosclerotic inflammation and that treatments for specific pathogens may provide clinical utility for CHD reduction.

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Multi-valvular infective endocarditis fromGemella morbillorum

Cited by 4 publications

References 44 publications

An Emerging Threat: A Systematic Review of Endocarditis Caused by Gemella Species

An Emerging Threat: A Systematic Review of Endocarditis Caused by Gemella Species

We Found a Gem in Your Heart: Valvular Heart Disease and Infective Endocarditis Discovered

Metagenomic Study of the MESA: Detection of Gemella Morbillorum and Association With Coronary Heart Disease

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