Acute Aortic Regurgitation Due to Endocarditis Caused by Disseminated Gonococcal Infection: A Case Report

Neto, Ana; Sevilha, Joana; Seabra, Daniel; Oliveira, Inês; Santos, Rui Pontes dos; Andrade, Aurora; Pinho, Paulo; Costa, Paula Martins da; Viana, Mariana Vitória Gomes; Pinto, Paula

doi:10.1097/olq.0000000000001251

Cited by 3 publications

(6 citation statements)

References 6 publications

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“…Another classic form of DGI is purulent arthritis, which usually presents abruptly in 1 or more joints, particularly the distal joints such as the knees, wrists, and ankles. 10 Other less common forms include endocarditis, 4 myopericarditis, 6 meningitis, 7 osteomyelitis, 5 and abscesses, such as in this patient who presented with a liver abscess. Blood cultures were positive in less than a third of cases.…”

Section: Discussionmentioning

confidence: 87%

“…Disseminated gonococcal infection (DGI) is an uncommon presentation that may manifest as skin lesions, arthralgia, tenosynovitis, or arthritis 3 . Rarely, bacteremia, endocarditis, myocarditis, osteomyelitis, and meningitis have been reported 4–7 . We report an exceedingly rare presentation of a liver abscess caused by N. gonorrhoeae in a 29-year-old woman with sickle cell disease.…”

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confidence: 95%

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Disseminated Gonorrhea Presenting as Liver Abscess in a Patient With Sickle Cell Disease

2022

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Section: Discussionmentioning

confidence: 87%

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confidence: 95%

Disseminated Gonorrhea Presenting as Liver Abscess in a Patient With Sickle Cell Disease

2022

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“…We have included citations of some previously reported cases since 1938 to our report for future reference of this interesting topic [6,[8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…It is a highly important diagnosis, given the occasionally difficult lab identification, the high degree of suspicion needed for diagnosis, and the significant proportion of associated fatal complications. Our case represents a valuable addition to the literature, and a comparison is provided with other cases of the post-antibiotic era [5,[8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 91%

Gonococcal Infective Endocarditis Returns

Said¹,

Tirthani²

2021

Cureus

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Disseminated gonococcal infection occurs in 0.5%-3% of gonorrhea cases, usually in the form of either a triad of arthralgia, tenosynovitis, and skin lesions or purulent arthritis. Other rare complications include gonococcal infective endocarditis that occurs in 1%-2% of cases with 99 cases reported in the literature since 1938. Our case presents an additional rare case of aortic valve gonococcal endocarditis requiring surgical intervention and a prolonged antibiotic course, despite the absence of genitourinary symptoms or mucosal evidence of infection. This case was found to have sepsis and gonococcal endocarditis, which was clearly confirmed with positive blood cultures and aortic valve vegetation. It was further complicated by the evidence of splenic embolization and severe aortic regurgitation requiring surgical valve replacement and debridement of an annular perivalvular abscess. A high degree of suspicion is needed to early diagnose these unusual cases of gonococcal endocarditis, especially in sexually active individuals, for its known virulence causing valve destruction and high mortality. Our case represents a valuable addition to the reported cases of this diagnosis and is complemented by a short literature review.

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“…Most N. gonorrhoeae strains that disseminate do not cause urethritis, but infection of a mucosal site usually precedes cases of disseminated disease [29]. Although uncommon, disseminated disease can cause arthritisdermatitis syndrome [30] and in rare cases endocarditis or meningitis [31][32][33][34]. Infection with N. gonorrhoeae can also facilitate transmission or acquisition of the human immunodeficiency virus type 1 (HIV-1) [35][36][37][38][39], and infection with N. gonorrhoeae has been reported to repress HIV-1 replication in macrophages inducing a state similar to viral latency [40].…”

Section: N Gonorrhoeae Infection and Diseasementioning

confidence: 99%

Vaccine Candidates for the Control and Prevention of the Sexually Transmitted Disease Gonorrhea

2021

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The World Health Organization (WHO) has placed N. gonorrhoeae on the global priority list of antimicrobial resistant pathogens and is urgently seeking the development of new intervention strategies. N. gonorrhoeae causes 86.9 million cases globally per annum. The effects of gonococcal disease are seen predominantly in women and children and especially in the Australian Indigenous community. While economic modelling suggests that this infection alone may directly cost the USA health care system USD 11.0–20.6 billion, indirect costs associated with adverse disease and pregnancy outcomes, disease prevention, and productivity loss, mean that the overall effect of the disease is far greater still. In this review, we summate the current progress towards the development of a gonorrhea vaccine and describe the clinical trials being undertaken in Australia to assess the efficacy of the current formulation of Bexsero® in controlling disease.

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Acute Aortic Regurgitation Due to Endocarditis Caused by Disseminated Gonococcal Infection: A Case Report

Cited by 3 publications

References 6 publications

Disseminated Gonorrhea Presenting as Liver Abscess in a Patient With Sickle Cell Disease

Disseminated Gonorrhea Presenting as Liver Abscess in a Patient With Sickle Cell Disease

Gonococcal Infective Endocarditis Returns

Vaccine Candidates for the Control and Prevention of the Sexually Transmitted Disease Gonorrhea

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