Rapidly Destructive Staphylococcus epidermidis Endocarditis

Abstract

A 29-year-old man with rapidly destructive Staphylococcus epidermidis endocarditis after mitral valve reconstruction is presented. Resistance to rifampin and teicoplanin occurred during antibiotic treatment resulting in clinical failure and valve destruction. Subsequently, the patient was successfully treated, by combining valve replacement with antibiotic therapy including quinupristin/dalfopristin, levofloxacin, and vancomycin. In conclusion, S. epidermidis can cause rapid valve destruction with large vegetations, and combination of surgery and antibiotic therapy may be necessary.

Staphylococcus lugdunensis Early Prosthetic Valve Endocarditis in a Young HIV Positive Patient

“…A subacute presentation is typical [7]. Rapidly destructive native valve endocarditis caused by CNS other than S. lugdunensis is a rare occurrence [8].…”

Endocarditis

“…Evidence of clinical benefi t with the use of rifampin against MRSE has been predominantly in patients with prosthetic valve endocarditis who were being concomitantly treated with glycopeptides and aminoglycosides [ 273 ] and is thus indicated in these situations [ 13 , 36 ]. The use of rifampin (along with teicoplanin) in CoNS-NVE was associated with emergence of rifampin resistance (and teicoplanin resistance) while on therapy in one patient [ 260 ]. A contributing factor may have been the simultaneous use of teicoplanin, an alternate glycopeptide, which has been associated with treatment failure when used in the management of staphylococcal endocarditis [ 13 ].…”

Very severe thrombocytopenia and fragmentation hemolysis mimicking thrombotic thrombocytopenic purpura associated with a giant intracardiac vegetation infected with Staphylococcus epidermidis: Role of monocyte procoagulant activity induced by bacterial supernatant

“…We report a patient with very severe thrombocytopenia (platelet count < 10 3 10 9 /l) without hemorrhagic manifestations. Blood cultures repeatedly grew Staphylococcus epidermidis-a coagulase-negative Staphylococcus species that is frequently implicated in prosthetic heart valve- [6,7], pacemaker, and intravenous catheterrelated endocarditis [8][9][10]. Further investigations showed pacemaker endocarditis with the pacemaker wire engulfed by a giant atrioventricular vegetation.…”