An Infected Bicuspid Aortic Valve, an Anomalous Coronary Artery, and a Dog-Bitten Postman

Abstract

Risk factors for infective endocarditis (IE) include congenital heart defects, poor dentition, immunosuppression, or recent instrumentation. The occupational hazard of a dog bite, combined with bicuspid aortic valve (BAV) led to IE. 16S ribosomal DNA was able to pinpoint the causative organism. A healthy 33-year-old postman presented in profound heart failure and sepsis due to aortic regurgitation and an aortic root abscess. He underwent emergency aortic valve replacement and was found to have a BAV and anomalous right coronary artery. Blood cultures remained negative. 16S ribosomal DNA polymerase chain reaction (PCR) revealed the causative organism was Capnocytophaga canimorsus. On review, he recalled receiving a dog bite followed by a febrile illness a few days later. Congenital BAVs may become infected by seemingly innocuous injuries. 16S rDNA PCR is a more sensitive and specific diagnostic test than culture. This case demonstrates its utility in providing appropriate antimicrobial management for IE.

Infective Endocarditis by Capnocytophaga Species—A Narrative Review

“…A total of 161 articles from PubMed and Scopus were screened. Finally, 31 met the present study’s inclusion criteria [ 5 , 6 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ]. These 31 studies involved 31 patients in total.…”

“…A total of 161 articles from PubMed and Scopus were screened. Finally, 31 met the present study's inclusion criteria [5,6,. These 31 studies involved 31 patients in total.…”

“…has been mainly described through case reports in the literature. Thus, the exact characteristics of IE by these bacteria have yet to be adequately described [ 5 , 6 ].…”

“…Infections in pregnancy may include chorioamnionitis, which is associated with an increased risk of perinatal complications such as preterm birth, fetal death, or perinatal disease in the offspring [ 9 , 20 ]. Other less frequent infections noted include osteomyelitis, peritonitis, aspiration pneumonia, urinary tract infections, and IE [ 5 , 6 , 9 , 21 , 22 , 23 ]. People with immunosuppression, such as asplenia or neutropenia, as well as other conditions, such as alcoholism, are at an increased risk of developing life-threatening infections from Capnocytophaga spp., and more specifically, from C. canimorsus (previously known as dysgonic fermenter-2) which is the most commonly isolated species in infected humans [ 24 , 25 ].…”

“…Given the rarity of IE caused by Capnocytophaga species, evidence regarding this condition in the literature is mainly based on case reports with or without a literature review [ 5 , 6 ]. The aim of this study was to review all previously described cases of IE by Capnocytophaga species and provide information about the epidemiology, microbiology, clinical characteristics, treatment, and outcomes of these infections.…”