Case Report: Infective Endocarditis of Mechanical Aortic Valve Due to Neisseria elongata Bacteremia

Abstract

Patient: Female, 53-year-old Final Diagnosis: Infective endocarditis of mechanical aortic valve Symptoms: Relapsing fevers with night sweats and generalized weakness Medication:— Clinical Procedure: — Specialty: Infectious Diseases Objective: Unknown etiology Background: Neisseria elongata is a infrequent cause of infective endocarditis (IE). Although considered a commensal bacterium of the human nasopharynx, N. elongata has been shown to be the cause of significant disease in humans, namely endocarditis, osteomyelitis, and septicemia. Case Report: We report the case of a 53-year-old man with a past medical history of mechanical aortic valve who presented to the hospital for evaluation of eleven days of recurrent and relapsing fevers and was admitted for severe sepsis with concern for endocarditis. Blood cultures revealed N. elongata bacteremia, and an echocardiogram did not show any vegetations, although it was limited by mechanical aortic valve shadowing. The patient recovered after six weeks of treatment with intravenous ceftriaxone and oral ciprofloxacin. Conclusions: Clinicians should be aware of the possibility of the previously considered non-pathogenic N. elongata as a source of IE caused by gram-negative organisms, as it can potentially cause severe disease and multiple complications. Our case additionally highlights that IE has highly variable clinical presentations. Thus, it is essential to utilize the Duke criteria as only a clinical guide for the diagnosis of IE rather than a substitute for clinical judgment and the decision to treat a patient with suspected IE.

Neisseria elongata–mediated peritonitis in an end-stage renal disease patient on automated peritoneal dialysis: a case report and literature review

“…N. elongata is an organism from the Neisseria genus. It is a gram-negative rod-shaped, catalase-negative bacteria that differentiates it from the other Neisseria species, which are diplococci in shape and catalase-positive 2 . Based on biochemical characteristics, N. elongata has three subspecies, elongate , glycolytic , and nitroreductase 2 .…”

Neisseria elongata -mediated peritonitis in an end-stage renal disease patient on automated peritoneal dialysis, A case report and literature review

“…Neisseria elongate is an organism from the Neisseria genus. It is a gram-negative rod-shaped, catalase-negative bacteria that differentiates it from the other Neisseria species, which are diplococci in shape and catalase positive [ 2 ]. based on biochemical characteristics, N.elongata has three subspecies, elongate , glycolytic , and nitroreductase [ 2 ] .…”