Prosthetic valve endocarditis resulting from Nocardia asteroides.

Falk, R. H.; Dimock, F; Sharkey, J

doi:10.1136/hrt.41.1.125

Cited by 21 publications

(13 citation statements)

References 5 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, only three cases of endocarditis due to the gram-positive Nocardia spp. have been reported in the literature, all in patients with prosthetic valves (74,76,289). A blood culture was positive in one patient (74), and the organism was isolated from a surgically excised valve in the other two.…”

Section: Gram-positive Bacillimentioning

confidence: 99%

Endocarditis Due to Rare and Fastidious Bacteria

2001

View full text Add to dashboard Cite

The etiologic diagnosis of infective endocarditis is easily made in the presence of continuous bacteremia with gram-positive cocci. However, the blood culture may contain a bacterium rarely associated with endocarditis, such as Lactobacillus spp., Klebsiella spp., or nontoxigenic Corynebacterium, Salmonella, Gemella, Campylobacter, Aeromonas, Yersinia, Nocardia, Pasteurella, Listeria, or Erysipelothrix spp., that requires further investigation to establish the relationship with endocarditis, or the blood culture may be uninformative despite a supportive clinical evaluation. In the latter case, the etiologic agents are either fastidious extracellular or intracellular bacteria. Fastidious extracellular bacteria such as Abiotrophia, HACEK group bacteria, Clostridium, Brucella, Legionella, Mycobacterium, and Bartonella spp. need supplemented media, prolonged incubation time, and special culture conditions. Intracellular bacteria such as Coxiella burnetii cannot be isolated routinely. The two most prevalent etiologic agents of culture-negative endocarditis are C. burnetti and Bartonella spp. Their diagnosis is usually carried out serologically. A systemic pathologic examination of excised heart valves including periodic acid-Schiff (PAS) staining and molecular methods has allowed the identification of Whipple's bacillus endocarditis. Pathologic examination of the valve using special staining, such as Warthin-Starry, Gimenez, and PAS, and broad-spectrum PCR should be performed systematically when no etiologic diagnosis is evident through routine laboratory evaluation

show abstract

Section: Gram-positive Bacillimentioning

confidence: 99%

Endocarditis Due to Rare and Fastidious Bacteria

2001

View full text Add to dashboard Cite

show abstract

“…Six reports of nocardial infective endocarditis of prosthetic valves were reported 1,8,[10][11][12]33 . In four out of them 1,8,10,11 blood cultures were positive, but only three patients survived after treatment: two patients underwent aortic valve replacement 10,11 , while the third one 8 was cured only on antibiotic treatment, like our patient.…”

mentioning

confidence: 99%

Nocardial infections: report of 22 cases

Chedid

Porto³

et al. 2007

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

SUMMARYTwenty-two cases of nocardial infections were diagnosed in our city between 1977-1998. All patients whose clinical specimens showed Nocardia spp. at Gram stain, which were further confirmed by culture, were selected to be included in the study. Data from patients who were cured were compared with those from patients who died by statistical tests using EPIINFO version 6.04 software. Six isolates were identified as Nocardia asteroides complex, one as Nocardia asteroides sensu stricto and other as Nocardia brasiliensis. We had 17 cases of lung nocardiosis, being one out of them also a systemic disease. Other four cases of systemic nocardiosis were diagnosed: nocardial brain abscesses (one); nocardiosis of the jejunum (one); multiple cutaneous abscesses (one); and a case of infective nocardial endocarditis of prosthetic aortic valve. One patient had a mycetoma by N. brasiliensis. Fifteen (68.2%) out of 22 patients were immunosuppressed, being most (93.3%) by high-doses corticotherapy. Mortality by nocardial infection was 41%; mortality of systemic nocardiosis was 60%. Nocardiosis has a bad prognosis in immunosuppressed patients and also in non-immunosuppressed patients if the diagnosis is delayed. We propose that the delay in diagnosis should be examined in larger series to document its influence in the prognosis of the disease.

show abstract

“…Nocardia asteroides is the usual culprit organism in human disease 4 . More than 95% of Nocardia species are sulfa sensitive 5,6 but surgical treatment is often necessary 6–8 . Nocardia has been reported as the cause of infective endocarditis following cardiac transplant, 9 superior vena cava obstruction, 7 native 10 and prosthetic 8 valve endocarditis, and septic 6 pericarditis.…”

Section: Discussionmentioning

confidence: 99%

“…4 More than 95% of Nocardia species are sulfa sensitive 5,6 but surgical treatment is often necessary. [6][7][8] Nocardia has been reported as the cause of infective endocarditis following cardiac transplant, 9 superior vena cava obstruction, 7 native 10 and prosthetic 8 valve endocarditis, and septic 6 pericarditis. Implantable cardiac device infection is infrequent and usually localized 11 to the PG pocket but cardiac extension, both endocardial 12 and epicardial, 13 has been reported.…”

Section: Discussionmentioning

confidence: 99%