Native bivalvular endocarditis byGemella haemolysansrequiring venovenous extracorporeal membrane oxygenation

Abstract

A 24-year-old otherwise healthy man presented with a 3-week history of malaise, headache, fever and rigors after he was treated with oral clindamycin for left parotitis and Gemella haemolysans bacteraemia. He developed G. haemolysans infective endocarditis, septic emboli and heart failure due to progressive bivalvular disease. He underwent urgent mechanical aortic valve replacement and mitral valve repair, which required venovenous extracorporeal membrane oxygenation, to support severe respiratory failure. This is the first documented case of G. haemolysans infective endocarditis affecting native aortic and mitral valves in a healthy adult.

Benefits of a Pre-Treatment Comprehensive Geriatric Assessment in a Rare Case of Gemella Haemolysans Endocarditis in an 86-Year-Old Patient and a Review of the Literature

“…According to our knowledge, only 24 documented cases of GH endocarditis have been reported until now including our case [6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. They have been summarized in Table 1.…”

Risk Factors and Patient Profile of Infective Endocarditis due to <i>Gemella spp.</i>

“…All studies were published between 1989 and 2019. The majority of studies were conducted in Europe and the UK [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 32 , 34 , 35 , 36 , 37 , 38 , 40 , 46 , 47 , 49 , 52 , 56 , 57 , 58 , 60 , 61 , 66 , 68 , 72 , 73 , 75 , 84 , 92 ] followed by North America [ 15 , 17 , 19 , 21 , 29 , 31 , 33 , 39 , 43 , 45 , 48 , 54 , 55 , 64 , 67 , 69 , 71 , 76 , 77 , 78 , 79 , 83 , 86 , 88 , 89 , 90 ] and Asia. [ 14 , 16 , 18 , 20 , 41 , 44 , 50 , 51 , 53 , 62 , 63 , 65 , 74 ,…”

“…Three articles investigated the association of endocarditis and cancer, particular colonic carcinoma [ 40 , 56 ] and multiple myeloma, [ 54 ] while four studies reported the association aneurysms and strokes. [ 21 , 27 , 44 , 63 ] The effects on the kidneys were discussed in four studies, [ 71 , 74 , 91 , 92 ] and four articles also reported concurrent implications of the heart, such as cardiogenic shock, STEMI, and hypertrophic cardiomyopathy. [ 47 , 50 , 70 , 86 ] Finally, three articles investigated the contribution of other infections within the body, such as septic arthritis, respiratory tract infection, and presence of anti-streptolysin-O antibodies.…”

“…The most common species was Gemella morbillorum (44.6%) [ 14 , 16 – 19 , 23 , 24 , 27 , 28 , 30 , 31 , 35 , 37 , 38 , 42 , 43 , 47 , 49 – 53 , 56 , 58 , 63 , 64 , 70 , 74 – 76 , 80 , 81 , 84 , 90 , 91 ] followed by Gemella haemolysans (26.5%). [ 15 , 21 , 22 , 25 , 26 , 32 , 36 , 40 , 46 , 48 , 52 , 54 , 59 – 61 , 68 , 69 , 72 , 73 , 88 , 92 ] The predominant strains in studies published in Europe and North America were Gemella morbillorum [ 17 , 19 , 23 , 24 , 27 , 28 , 30 , 31 , 35 , 37 , 38 , 43 , 47 , 49 , 52 , 56 , 57 , 64 , …”

Veno arterial-extra corporal membrane oxygenation for the treatment of cardiac failure in patients with infective endocarditis

“…13 When considering VA-ECMO postcardiotomy for patients who were operated on for IE, there is only anecdotal data on the subject but no larger case series exist. [15][16][17] The purpose of this study is to present a larger cohort of patients who underwent cardiac surgery for IE and received subsequent VA-ECMO treatment as data in this field are virtually non-existent. It could provide a proof of concept on the subject and may be the starting point for future research and could help in establishing guidelines for the indication for VA-ECMO support in post-cardiotomy patients.…”