A Case Report of Successful Conservative Treatment for Infective Endocarditis Caused byGemella sanguinis

Abstract

Infective endocarditis is defined as an infection of a native or prosthetic heart valve, the endocardial surface of the heart, or an indwelling cardiac device. Among the miscellaneous emerging opportunistic bacteria that can cause infective endocarditis is Gemella sanguinis that has been reported as a cause of infective endocarditis in nine cases in the past. All of the survivors received antimicrobial therapy and underwent prosthetic valve replacement surgery while, in general, a proportion of 40–50% of the patients with infective endocarditis underwent valve surgery. Our case illustrates that valve surgery, in combination with the administration of antibiotics, is not the only therapeutic option for infective endocarditis due to Gemella sanguinis and that a conservative management with prolonged administration of parenteral antibiotics under close supervision of the patient can be an option.

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 ,…”

“…[ 14 , 52 , 65 ] Two articles were missing either sex [ 14 ] or age [ 52 ] with regards to demographic characteristics. Fifteen case reports did not have satisfy the patient’s history and timeline criteria, [ 18 , 25 , 32 , 34 , 40 , 44 , 45 , 49 , 51 , 56 , 58 , 59 , 62 , 65 , 92 ] while five articles omitted details of intervention. [ 14 , 52 , 65 , 77 , 86 ] 71.4% of studies did not include the post-intervention clinical condition of the patients and/or adverse or unanticipated events.…”

“…[ 14 , 52 , 65 , 77 , 86 ] 71.4% of studies did not include the post-intervention clinical condition of the patients and/or adverse or unanticipated events. [ 14 , 15 , 16 , 18 , 19 , 22 – 26 , 28 – 32 , 34 , 36 – 43 , 46 – 50 , 52 , 53 , 57 – 63 , 65 – 68 , 71 – 73 , 76 – 78 , 80 , 81 , 84 , 85 , 87 , 89 , 90 , 92 ]…”

“…in adult patients with infective endocarditis. [ 14 – 20 , 24 , 25 , 29 , 30 , 32 – 34 , 36 , 38 , 39 , 41 – 43 , 46 , 48 , 49 , 52 , 53 , 57 – 60 , 64 – 66 , 68 , 69 , 72 , 73 , 75 – 85 , 87 – 90 ] While the majority of these studies reported the presence of the bacteria in predominantly native-valves, [ 14 – 16 , 18 , 20 , 24 , 25 , 29 , 30 , 32 – 34 , 36 , 38 , 41 , 43 , 46 , 48 , 49 , 52 , 53 , 57 – 59 , 64 , 65 , 68 , 72 , 77 – 81 , 83 – 85 , 87 – 89 ] 12 of those studies highlighted the association of prosthetic valve endocarditis by Gemella spp. [ 17 , 19 , 39 , 42 , 60 , 66 ,…”

Evaluation of Extraction Methods for Clinical Metagenomic Assay

“…Other species from the same genus, Gemella morbillorum (2887 f) and Gemella sanguinis (4067 f), were detected in the sample. These three bacteria are known as normal microbiota of the mouth and have been reported as opportunistic pathogens that can cause some severe infections, which often occur in previously damaged tissue [20,21].…”