Infective endocarditis by a rare and fastidious agent:<i>Abiotrophia defectiva</i>

Mosca, Ana; Mané, Fenando; Pires, C Marques; Medeiros, P

doi:10.1136/bcr-2021-241964

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…Abiotrophia defectiva is a Gram-positive streptococcus that colonizes in the oral cavity, gastrointestinal tract and urogenital tract of healthy individuals. It rarely causes IE that predominantly occurs in adults with structural heart disease, immunosuppression, prosthetic valves and invasive operations (such as dental procedures) [ 7 , 8 ]. Atypical clinical presentation and fastidious nutritional make delays in the diagnosis and treatment of IE due to Abiotrophia defective [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

A rare association of invasive infective endocarditis due to Abiotrophia defectiva with ventricular septal defect and recurrent Henoch-Schonlein purpura in a child

Dong

Zhou

2022

J Cardiothorac Surg

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Background Henoch-Schonlein purpura is the most common vasculitis in childhood, usually triggered by an upper respiratory tract infection and rarely observed in infective endocarditis patients. Abiotrophia defectiva is a rare causative agent of infective endocarditis associated with pre-existing heart disease, immunocompromised and prosthetic valves. Dental procedures are also a common predisposing factor. Case presentation We present the first pediatric congenital heart disease case of infective endocarditis caused by Abiotrophia defectiva combined with recurrent Henoch-Schonlein purpura. A 10-year-old girl with uncorrected congenital heart defects and Henoch-Schonlein purpura developed a purple petechial rash again. Transthoracic echocardiography evaluation revealed multiple irregular vegetations on the right ventricular side of the ventricular septal defect and on the tricuspid valve leaflets. Blood cultures grew Abiotrophia defectiva. The girl received cardiac surgery for vegetation resection as well as congenital heart defect correction and tricuspid valve replacement. Five months after the surgery, the patient was in satisfactory condition without any signs of endocarditis or valve insufficiency and her purpuric rash disappeared. Conclusions The coexistence of recurrent Henoch-Schonlein purpura and infective endocarditis is possible. Abiotrophia defectiva belongs to the streptococcus with a high virulence. In addition, cardiovascular surgery is often required for pediatric infective endocarditis associated with Abiotrophia defectiva, and bioprosthetic valve replacement is considered feasible for irreparable tricuspid valve in children.

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Section: Discussionmentioning

confidence: 99%

A rare association of invasive infective endocarditis due to Abiotrophia defectiva with ventricular septal defect and recurrent Henoch-Schonlein purpura in a child

Dong

Zhou

2022

J Cardiothorac Surg

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“…Insidious, subacute or chronic course of the disease may be caused by atypical pathogens such as Abiotrophia defectiva. It is thought to be responsible for 4–8 % of streptococcal endocarditis and about 1–2 % of the total IE [1] , [2] , [3] . Although A.defectiva belongs to the normal flora of the oral cavity, gastrointestinal tract and urogenital tract, it can lead to severe IE with the development of large vegetations, valves destruction, progressive heart failure and embolic events [4] .…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of complications, treatment failure, need for valve replacement and mortality rate are higher compared to IE caused by common pathogens. Moreover, A.defectiva is difficult to isolate, requires specialized culture media and is responsible for the majority of negative cultures [1] , [2] , [3] .…”

Section: Introductionmentioning

confidence: 99%

Abiotrophia defectiva endocarditis – Diagnostic and therapeutic challenge: Case report

Wilawer,

Elikowski,

Greberski

et al. 2023

IDCases

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“…Although their role as causative agents of IE is known [7][8][9][10][11], their incidence, diagnostic and clinical management is not completely defined. Most data published in the literature report single clinical cases, with heterogeneous char-acteristics [12][13][14][15], and data on the real impact of this entity are very scarce. Case series described focus on clinical aspects, providing scarce information on the role of microbiological diagnosis [16,17].…”

Section: Introductionmentioning

confidence: 99%

Abiotrophia spp. and Granulicatella spp. Infective Endocarditis: A Contemporary Perspective

Estévez¹,

Marı́n²,

Sánchez‐Carrillo³

et al. 2022

Front. Biosci. (Elite Ed)

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Background: Abiotrophia spp. and Granulicatella spp. are Gram-positive cocci, formerly known as nutritionally variant or deficient Streptococcus. Their role as causative agents of infective endocarditis (IE) is numerically uncertain, as well as diagnostic and clinical management of this infection. The aim of our study is to describe the clinical, microbiological, therapeutic, and prognosis of patients with IE caused by these microorganisms in a large microbiology department. Methods: Retrospective analysis of all the patients with Abiotrophia spp. and Granulicatella spp. IE registered in our centre in the period 2004-2021. Results: Of the 822 IE in the study period, 10 (1.2%) were caused by Abiotrophia spp. (7) or Granulicatella spp. (3). The species involved were A.defectiva (7), G.adiacens (2) and G.elegans (1). Eight patients were male, their mean age was 46 years and four were younger than 21 years. The most frequent comorbidities were congenital heart disease (4; 40%) and the presence of intracardiac prosthetic material (5; 50%). IE occurred on 5 native valves and 5 prosthetic valve or material. Blood cultures were positive in 8/10 patients, within a mean incubation period of 18.07 hours. In the other two patients, a positive 16SPCR from valve or prosthetic material provided the diagnosis. Surgery for IE was performed in seven patients (70%) and in all cases positive 16S rRNA PCR and sequencing from valve or prosthetic material was demonstrated. Valves and/or prosthetic removed material cultures were positive in four patients. Nine patients received ceftriaxone (4 in monotherapy and 5 in combination with other antibiotics). The mean length of treatment was 6 weeks and IE-associated mortality was 20% at one year follow-up. Conclusions: Abiotrophia spp. or Granulicatella spp. IE were infrequent but not exceptional in our environment and particularly affected patients with congenital heart disease or prosthetic material. Blood cultures and molecular methods allowed the diagnosis. Most of them required surgery and the associated mortality, in spite of a mean age of 46 years, was high.

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Infective endocarditis by a rare and fastidious agent:Abiotrophia defectiva

Cited by 3 publications

References 23 publications

A rare association of invasive infective endocarditis due to Abiotrophia defectiva with ventricular septal defect and recurrent Henoch-Schonlein purpura in a child

A rare association of invasive infective endocarditis due to Abiotrophia defectiva with ventricular septal defect and recurrent Henoch-Schonlein purpura in a child

Abiotrophia defectiva endocarditis – Diagnostic and therapeutic challenge: Case report

Abiotrophia spp. and Granulicatella spp. Infective Endocarditis: A Contemporary Perspective

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