Hemolytic Anemia in a Patient with Subacute Bacterial Endocarditis by <i>Cardiobacterium hominis</i>

Abstract

Hemolytic anemia is a rarely occurring manifestation of native valve infective endocarditis. We herein report an afebrile patient with hemolytic anemia caused by Cardiobacterium hominis endocarditis. A 60-yearold Japanese man had a history of aortic root replacement and the gradual onset of general fatigue. He had hemolytic anemia. Blood cultures detected C. hominis. A transthoracic echocardiogram showed aortic valve vegetation and periannular abscess with perforation of the non-coronary cusp. Intravascular hemolysis recovered after antimicrobial therapy, surgical removal of the vegetation and abscess, and aortic valve replacement. Subacute endocarditis should be considered if patients develop hemolytic anemia with signs of chronic inflammation without a fever.

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“…Another potential cause of the cardiac physical examination findings in the patient is bacterial endocarditis caused by bacteremia. Although MRSA was cultured from the patient's blood, a cardiac echo was done to rule out bacterial endocarditis [22]. The results of the chest CT scan supported a diagnosis of septic pulmonary embolism caused by MRSA, which is consistent with the presentation of the patient.…”

Cardiobacterium hominis endocarditis associated with cerebral, renal, and splenic infarctions: A case report and review of the literature

“…C. hominis is also known to cause large friable vegetations complicated by systemic embolism [11] . Therefore, we reviewed cases of systemic embolism caused by C. hominis IE ( Table 2 ) [5] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] . 21 cases of C. hominis IE associated with embolism, including the present case, have been reported since 1980.…”

A Potential Role of Hematologic Abnormalities as Prognostic Markers an Infective Endocarditis (IE)

“…Antierythrocyte antibodies may arise by crossreaction between invading microorganisms and erythrocytes, leading to their destruction in the spleen. Circulating immune complexes may also induce thrombotic thrombocytopenic purpura (TTP)-like syndrome and red cell fragmentation [20].…”