Campylobacter fetus prosthetic valve endocarditis presenting as a stroke

Abstract

IntroductionCampylobacter is a common pathogen of the gastrointestinal tract, but invasive disease is rare. Campylobacter fetus can play a role in osteomyelitis, meningitis and joint infection and has a prediliction for the vascular endothelium, causing mycotic aneurysms, thrombophlebitis and endocarditis. Here we present a case of prosthetic valve endocarditis caused by C. fetus and a review of the literature.Case presentationAn 85-year-old woman with a tissue aortic valve replacement and atrial fibrillation was admitted to hospital with tonic-clonic seizures, right-sided hemiparesis, facial droop and hemianopia. Multiple cerebral emboli were seen on magnetic resonance imaging of the brain. Blood cultures grew C. fetus and an echocardiogram showed thickening and restricted movement of the aortic valve, a significant difference from an echocardiogram done 2 months before when the same organism was again isolated in blood cultures. She improved after treatment with 6 weeks of amoxicillin and 2 weeks of synergistic gentamicin for prosthetic valve endocarditis.ConclusionThere have only been five previously reported cases of C. fetus prosthetic valve endocarditis and this is the only patient who presented as a stroke. The majority of surviving patients required replacement of the affected valve with only one other patient surviving in the absence of surgery. No guidelines exist on the optimum treatment of C. fetus endocarditis and this case reports adds to the growing literature on the appropriate management for this rare and potentially devastating disease.

Prosthetic valve endocarditis caused by Campylobacter fetus: a case report and literature review

“…12 Untreated PVE caused by C. fetus is associated with a high mortality rate and can lead to various complications, such as septic emboli or perivalvular extension. 2…”

“…21 Low MICs for imipenem, meropenem, gentamicin, and erythromycin were also observed in earlier cases of PVE caused by C. fetus . 2,4,6,9…”

“…21 Low MICs for imipenem, meropenem, gentamicin, and erythromycin were also observed in earlier cases of PVE caused by C. fetus. 2,4,6,9 The cause and route of C. fetus infection are still unclear, but this infection is thought to occur after exposure to contaminated food from cattle and sheep, with predisposing factors such as immunosuppression and valve abnormalities. 12 Our patient was immunocompetent; therefore, how he became infected is unclear, and we assume that bacteremia caused by C. fetus contributed to his PVE and worsened systemic condition.…”

Phenotypic and genetic analyses of two Campylobacter fetus isolates from a patient with relapsed prosthetic valve endocarditis

“…In this paper, we describe two Cff isolates (CITCf01 and CITCf02) recovered in 2017 and 2018, respectively from blood cultures of an Irish patient with recurrent prosthetic valve endocarditis, that were marked for their ability to grow aerobically. Reports of C. fetus causing prosthetic valve endocarditis are limited (Caramelli et al 1988;Farrugia, Eykyn and Smyth 1994;Peetermans et al 2000;Haruyama et al 2011;Reid et al 2016;Petridou, Strakova and Simpson 2018). In this study, our aim was to investigate the phenotypic characteristics, antimicrobial resistance (AMR), genomic composition and phylogeny of such isolates.…”

Aneurisma de la aorta abdominal infectado por Campylobacter fetus. Comunicación de un caso clínico y revisión de la literatura médica

“…Si bien no encontramos guías que recomienden la realización de ecocardiografía de rutina en pacientes con bacteriemia por C. fetus, dado el tropismo de este microorganismo por el endotelio vascular, debe descartarse la endocarditis infecciosa como posible fuente de bacteriemia. Se han reportado casos clínicos de endocarditis secundarias a C. fetus, requiriendo la mayoría tratamiento quirúrgico [19][20][21] . En nuestro paciente se descartó la endocarditis con una ecocardiografía transtorácica.…”