Double-Valve Heart Disease and Glomerulonephritis Consequent to Abiotrophia defectiva Endocarditis

Abstract

Abiotrophia defectiva, a nutritionally deficient streptococcus, is a rare cause of infective endocarditis. It has been associated with hemophagocytic syndrome. We present the first case of A. defectiva infective endocarditis that led to antineutrophil cytoplasmic antibody-associated glomerulonephritis. The patient was a 55-year-old man whose endocarditis affected the mitral and aortic valves. His course was complicated by atrial fibrillation, stroke, and glomerulonephritis. He was successfully treated with antibiotics and dual valve replacement.

Pyridoxine-Deficient Streptococcus: An Uncommon Virulent Cause of Subacute Destructive Aortic Valve Endocarditis

“…The AV is more commonly affected than other valves, consistent with our case, and AVR is indicated in 30% of cases [5]. The American Heart Association recommends treatment with penicillin or ceftriaxone and gentamycin for four to six weeks (vancomycin in penicillin-allergic patients) [1][2][3][4][5][6]. Early surgery is associated with better outcomes in patients with severe valvular disease and large vegetations [4].…”

“…It is associated with a high risk of complications and mortality. NVS usually resides in the oral cavity, intestinal tract, or genitourinary tract, and can manifest as culture-negative endocarditis, osteomyelitis, or septic arthritis with a high propensity for septic emboli (30%) [1][2][3][4][5]. Here we present an unusual case of NVS subacute endocarditis of the aortic valve (AV) complicated by severe aortic regurgitation (AR) necessitating aortic valve replacement (AVR).…”

Abiotrophia defectiva endocarditis – Diagnostic and therapeutic challenge: Case report

“…Infrequently, the primary infection affects the urinary tract [10] . The secretion of exopolysaccharide and the ability to adhere to fibinoectin explains the affinity of A. defectiva to endovascular tissue and predisposition to the development of large vegetations [11] . The insidious but aggressive course of IE with such vegetations is associated with a particular risk of systemic embolization, severe valve destruction and progressive valvular regurgitation.…”

Abiotrophia defectiva as a Rare Causative Agent of Periprosthetic Total Knee Arthroplasty Infections: A Case Report and Literature Review

“…Exopolysaccharide and fibronectin are key virulence factors of A. defectiva and provide a strong binding capacity to endovascular structures and prosthetic surface. 3 4 Although there are a vast number of case reports dealing with Abiotrophia endocarditis in the medical literature, Abiotrophia infections associated with prosthetic joint replacement are uncommon and have been sporadically reported. 4 To the best of our knowledge, the literature has described only a few of orthopaedic prosthesis-associated A. defectiva infections to date…”

“…A. defectiva specifically targets endovascular structures, and it is reported to be a key agent in cases of culture-negative endocarditis. 2 3 Furthermore, this fastidious pathogen has been associated with osteoarticular and prosthetic joint infections. Knee prosthesis infections caused by A. defectiva have been reported sporadically.…”