Nocardial endocarditis after aortic valve replacement: Reports of Two Cases

Eigel, P; Elert, O.; Hopp, H.; Silber, RE; Romen, W; Schmidt-Rotte, H.

doi:10.3109/14017438809106078

Cited by 18 publications

(16 citation statements)

References 5 publications

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“…In four out of them 1,8,10,11 blood cultures were positive, but only three patients survived after treatment: two patients underwent aortic valve replacement 10,11 , while the third one 8 was cured only on antibiotic treatment, like our patient. In our patient it was not identified any other foci of nocardiosis and the infection occurred eight years after the surgery; he had two positive blood cultures to Nocardia spp.…”

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confidence: 49%

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Nocardial infections: report of 22 cases

Chedid

Porto³

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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SUMMARYTwenty-two cases of nocardial infections were diagnosed in our city between 1977-1998. All patients whose clinical specimens showed Nocardia spp. at Gram stain, which were further confirmed by culture, were selected to be included in the study. Data from patients who were cured were compared with those from patients who died by statistical tests using EPIINFO version 6.04 software. Six isolates were identified as Nocardia asteroides complex, one as Nocardia asteroides sensu stricto and other as Nocardia brasiliensis. We had 17 cases of lung nocardiosis, being one out of them also a systemic disease. Other four cases of systemic nocardiosis were diagnosed: nocardial brain abscesses (one); nocardiosis of the jejunum (one); multiple cutaneous abscesses (one); and a case of infective nocardial endocarditis of prosthetic aortic valve. One patient had a mycetoma by N. brasiliensis. Fifteen (68.2%) out of 22 patients were immunosuppressed, being most (93.3%) by high-doses corticotherapy. Mortality by nocardial infection was 41%; mortality of systemic nocardiosis was 60%. Nocardiosis has a bad prognosis in immunosuppressed patients and also in non-immunosuppressed patients if the diagnosis is delayed. We propose that the delay in diagnosis should be examined in larger series to document its influence in the prognosis of the disease.

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confidence: 49%

“…Six reports of nocardial infective endocarditis of prosthetic valves were reported 1,8,[10][11][12]33 . In four out of them 1,8,10,11 blood cultures were positive, but only three patients survived after treatment: two patients underwent aortic valve replacement 10,11 , while the third one 8 was cured only on antibiotic treatment, like our patient.…”

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confidence: 99%

Nocardial infections: report of 22 cases

Chedid

Porto³

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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“…Regarding Nocardiainduced SSO, Wenger and colleagues reported in 1998 the first nosocomial N. farcinica sternotomy site infection outbreak (5 patients) following open heart surgery, which was linked to hand contamination of an anesthesiologist [20]. Another 3 cases of Nocardia-induced SSO (2 of them by N. asteroides) have been reported after heart valve replacement [21,22].…”

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confidence: 99%

Primary sternal osteomyelitis caused by Nocardia nova: case report and literature review

Baraboutis¹,

Argyropoulou²,

Papastamopoulos³

et al. 2008

Braz J Infect Dis

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A 51 year old woman without significant past medical history or risk factors for Nocardia infection developed primary Nocardia nova sternal osteomyelitis with mediastinal abscess, diagnosed with open biopsy. She required prolonged antibiotic therapy and had a favorable outcome. Primary sternal osteomyelitis develops in the absence of a contiguous focus of infection, as opposed to secondary sternal osteomyelitis, which is usually a complication of sternotomy. Staphylococcus aureus probably still is the most common cause of both forms of sternal osteomyelitis. Nocardia species invade humans usually through the respiratory tract and can cause a variety of localized infections through the hematogenous route. Pulmonary involvement may or may not coexist. Immunosuppressed patients are more prone to infection by Nocardia species, although cases involving seemingly immunocompetent patients are not rare. This is the first reported case in the English literature of primary sternal osteomyelitis due to Nocardia nova or any other Nocardia species.

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“…Infective endocarditis caused by nocardia is very rare. We searched the PubMed and Scopus databases (the terms used for the search were nocardia, endocarditis) and only twenty cases of nocardia endocarditis have been described in the literature since 1973 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. We present the twenty-first case.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Nocardia Farcinica Prosthetic Valvular Endocarditis without Valvular Replacement

Einarsdóttír¹,

Gudmundsdottir²,

Torfason³

et al. 2015

AJMCR

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We report a case of prosthetic valve nocardia endocarditis. A 43 year old farmer underwent aortic valve replacement with a bioprosthetic valve. The immediate post-operative course was uneventful but 2 weeks later he developed fever. A trans-oesophageal echocardiogram (TEE) showed a string like structure attached to the prosthetic valve. Blood cultures grew N. farcinica. He was initially treated with trimethoprim/sulfamethoxazole (TMP/SMZ), but due to eosinophilia and leucopenia his treatment was changed to imipenem and amikacin. He developed a rash, presumed to be due to imipenem, which was then substituted with linezolid. He completed a 6 week course of intravenous (i.v.) antibiotics. Desensitization with amoxicillin/clavulanic acid was successful and the patient received oral amoxicillin/clavulanic acid for 6 months. At present, 12 months from diagnosis, he is afebrile and TEE is normal. To our knowledge, this case is the fifth reported case of successful treatment of prosthetic valve nocardia endocarditis treated without surgery.

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Nocardial endocarditis after aortic valve replacement: Reports of Two Cases

Cited by 18 publications

References 5 publications

Nocardial infections: report of 22 cases

Nocardial infections: report of 22 cases

Primary sternal osteomyelitis caused by Nocardia nova: case report and literature review

Successful Treatment of Nocardia Farcinica Prosthetic Valvular Endocarditis without Valvular Replacement

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