Prosthetic Valve Endocarditis Caused by Gemella sanguinis: A Consequence of Persistent Dental Infection

Gundre, Prashant; Pascal, William; Kupfer, Yizhak; Tessler, Sidney; Abrol, Sunil

doi:10.1097/maj.0b013e31821389f0

Cited by 12 publications

(13 citation statements)

References 5 publications

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“…In our patient, there was no identifiable predisposing factor or source of infection. Her affected valve was the mitral valve while in the previous reports the aortic valve was affected in five cases [3, 8, 9, 11, 12], the mitral valve in two [7], and tricuspid valve in one [5]. Furthermore, in our case, the patient received intravenous antibiotics for a prolonged time, and the same treatment was also followed in 8 out of the 9 reported cases (for the remaining one, information is not available).…”

Section: Discussionmentioning

confidence: 97%

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A Case Report of Successful Conservative Treatment for Infective Endocarditis Caused byGemella sanguinis

Emmanouilidou

Voukelatou

Vrettos

et al. 2019

Case Reports in Infectious Diseases

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Infective endocarditis is defined as an infection of a native or prosthetic heart valve, the endocardial surface of the heart, or an indwelling cardiac device. Among the miscellaneous emerging opportunistic bacteria that can cause infective endocarditis is Gemella sanguinis that has been reported as a cause of infective endocarditis in nine cases in the past. All of the survivors received antimicrobial therapy and underwent prosthetic valve replacement surgery while, in general, a proportion of 40–50% of the patients with infective endocarditis underwent valve surgery. Our case illustrates that valve surgery, in combination with the administration of antibiotics, is not the only therapeutic option for infective endocarditis due to Gemella sanguinis and that a conservative management with prolonged administration of parenteral antibiotics under close supervision of the patient can be an option.

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Section: Discussionmentioning

confidence: 97%

“…One patient died because of intracerebral bleeding caused by a ruptured cerebral mycotic aneurysm [8]. In the other seven cases, all the patients needed prosthetic valve replacement surgery [3, 5, 7, 9–12]. Overall, 40–50% of patients with infective endocarditis underwent prosthetic valve replacement surgery [14].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Successful Conservative Treatment for Infective Endocarditis Caused byGemella sanguinis

Emmanouilidou

Voukelatou

Vrettos

et al. 2019

Case Reports in Infectious Diseases

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“…When the infection has progressed enough to allow bacteria to overwhelm the dental pulp tissue, a toothache can result, and if left untreated, the pain worsens with exposure to heat, cold, or sweet foods and drinks (Marcenes et al, 2013 ). In highly progressed cases, infection can spread from the affected tooth to the surrounding soft tissues, resulting in complications such as phylogenetic osteomyelitis (Baur et al, 2012 ) and bacterial endocarditis (Gundre et al, 2011 ), which can be life threatening. Once caries occurs, the damage to teeth is irreversible; thus, preventive intervention of caries in children is of particular clinical significance ( 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Profiling of Oral Microbiota in Early Childhood Caries Using Single-Molecule Real-Time Sequencing

et al. 2017

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Background: Alterations of oral microbiota are the main cause of the progression of caries. The goal of this study was to characterize the oral microbiota in childhood caries based on single-molecule real-time sequencing.Methods: A total of 21 preschoolers, aged 3–5 years old with severe early childhood caries, and 20 age-matched, caries-free children as controls were recruited. Saliva samples were collected, followed by DNA extraction, Pacbio sequencing, and phylogenetic analyses of the oral microbial communities.Results: Eight hundred and seventy six species derived from 13 known bacterial phyla and 110 genera were detected from 41 children using Pacbio sequencing. At the species level, 38 species, including Veillonella spp., Streptococcus spp., Prevotella spp., and Lactobacillus spp., showed higher abundance in the caries group compared to the caries-free group (p < 0.05). The core microbiota at the genus and species levels was more stable in the caries-free micro-ecological niche. At follow-up, oral examinations 6 months after sample collection, development of new dental caries was observed in 5 children (the transitional group) among the 21 caries free children. Compared with the caries-free children, in the transitional and caries groups, 6 species, which were more abundant in the caries-free group, exhibited a relatively low abundance in both the caries group and the transitional group (p < 0.05). We conclude that Abiotrophia spp., Neisseria spp., and Veillonella spp., might be associated with healthy oral microbial ecosystem. Prevotella spp., Lactobacillus spp., Dialister spp., and Filifactor spp. may be related to the pathogenesis and progression of dental caries.

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“…Gemella sanguinis is a gram-positive, catalase-negative, streptococcus-like bacterium first described in 1998 [ 10 ], which is part of the normal human oropharynx, urogenital and gastrointestinal flora [ 18 ]. To date, three cases of G. sanguinis endocarditis have been described and all were associated with poor oral hygiene [ 8 , 9 ]. However, G. sanguinis has never been reported as a cause of positive c-ANCA/anti-PR-3.…”

Section: Discussionmentioning

confidence: 99%

“…Several bacterial species have been reported in cases of endocarditis associated with positive c-ANCA [ 6 ], including Gemella morbillorum [ 7 ]. Gemella sanguinis is a rare cause of endocarditis that has only been previously reported in three cases [ 8 – 10 ]. We report the first case of G. sanguinis endocarditis with c-ANCA/anti-PR3 positivity and its association with a focal necrotizing glomerulonephritis with full-house immune complex deposition (IgA, IgG, IgM, C3 and C1q positive).…”

Section: Introductionmentioning

confidence: 99%

Gemella sanguinis endocarditis with c-ANCA/anti-PR-3-associated immune complex necrotizing glomerulonephritis with a 'full-house' pattern on immunofluorescence microscopy

Rousseau-Gagnon

Riopel

Desjardins

et al. 2013

Clinical Kidney Journal

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A 67-year-old man was evaluated for haematuria, with a rising creatinine level from 88 to 906 µmol/L and positive c-anti-neutrophil cytoplasm antibody (ANCA)/anti-proteinase 3 (anti-PR3). A kidney biopsy revealed necrotizing glomerulonephritis with a ‘full-house’ pattern on immunofluorescence microscopy. Echocardiography and blood cultures growing Gemella sanguinis diagnosed endocarditis. Dialysis was required for a month. Three months later, following valve replacement, glucocorticoids and 2 months of antibiotic therapy, the creatinine level decreased to 62 µmol/L and c-ANCA/anti-PR3 disappeared. This first case of c-ANCA/anti-PR3 positive glomerulonephritis with a ‘full-house’ immunofluorescence pattern due to bacterial endocarditis underlines the importance of ruling out infection with ANCA positivity or kidney biopsy suggestive of lupus nephritis.

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Prosthetic Valve Endocarditis Caused by Gemella sanguinis: A Consequence of Persistent Dental Infection

Cited by 12 publications

References 5 publications

A Case Report of Successful Conservative Treatment for Infective Endocarditis Caused byGemella sanguinis

A Case Report of Successful Conservative Treatment for Infective Endocarditis Caused byGemella sanguinis

Profiling of Oral Microbiota in Early Childhood Caries Using Single-Molecule Real-Time Sequencing

Gemella sanguinis endocarditis with c-ANCA/anti-PR-3-associated immune complex necrotizing glomerulonephritis with a 'full-house' pattern on immunofluorescence microscopy

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