Spontaneous endocarditis caused by rapidly growing non-tuberculous Mycobacterium chelonae in an immunocompetent patient with rheumatic heart disease

Jagadeesan, Naveena; Patra, Soumya; Singh, Ajit Pal; Nagesh, CM; Reddy, Babu; Badnur, Srinivas C.; Nanjappa, Manjunath Cholenahally

doi:10.1016/j.jcdr.2013.06.003

Cited by 6 publications

(14 citation statements)

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“…The major symptoms on admission were described in 46 patients including fever in 35 (76.1%) [ 7 , 9 - 29 , 33 , 37 , 38 ] , dyspnea in 10 (21.7%) [ 10 , 11 , 31 , 32 ] and chest pain in 1 (2.1%) patient [ 30 ] (χ 2 =60.7, P =0.000). The duration of the symptoms was 4.0±4.4 (range, 0.17-18; median, 2) months (n=31).…”

Section: Resultsmentioning

confidence: 99%

“…The temperature of the febrile patients were 38.9±0.8℃ (n=12). Of the febrile patients, fever grade was not indicated in 22 [ 11 , 14 , 18 , 23 , 24 , 26 , 28 , 29 , 33 , 35 , 36 , 38 ] . In the remaining 13 patients, 5 (38.5%) had a high fever [ 12 , 17 , 19 , 20 , 22 , 29 ] , 5 (38.5%) had a moderate fever [ 13 , 15 , 21 , 25 , 34 ] and 3 (23.1%) had a low-grade fever [ 9 , 27 , 37 ] (χ 2 =0.9, P =0.630).…”

Section: Resultsmentioning

confidence: 99%

“…The cardiac murmur was mentioned in 15 patients: a cardiac murmur in 12 (80%) (a pansystolic murmur at the apex in 5 [ 14 , 21 , 27 , 30 , 38 ] , a diastolic murmur in the aortic region in 2 [ 13 , 18 ] , a systolic murmur in the aortic region [ 36 ] , a pansystolic murmur at the apex + a diastolic murmur in the aortic region [ 25 ] , a pansystolic murmur at the apex + a systolic murmur in the aortic region [ 15 ] , a systolic murmur at the lower left sternal boarder [ 37 ] and an unspecified cardiac murmur [ 32 ] in 1 patient each) and an absence of a cardiac murmur in 3 (20%) patients [ 20 , 22 , 24 ] (χ 2 =10.8, P =0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Laboratory examinations revealed their hemoglobin was 9.9±1.8 (range, 5.9-12.5; median, 10) g/L (n=10) [ 9 , 10 , 12 , 13 , 15 , 18 , 20 , 27 , 30 , 36 , 38 ] , white blood cell count was 8.9±4.4 (range, 3.3-16.8; median, 8.2) ×10 9 /L (n=13) [ 9 , 10 , 13 , 15 , 20 - 22 , 24 , 27 , 28 , 30 , 33 , 38 ] , platelet count was 165.6±128.7 (range, 67-450; median, 124)×10 9 /L (n=7) [ 10 , 13 , 15 , 18 , 20 , 27 , 38 ] , C-reaction protein was 6.8±4.7 (range, 0.14-11; median, 8) mg/dL (n=4) [ 10 , 20 , 27 , 28 ] , and CD4 was 240.5 ± 206.3 (range, 44-587; median 196)/mm 3 (n=6) [ 9 , 10 , 13 , 14 , 19 , 37 ] . CD4 was normal (>500/mm 3 ) in 1 (16.7%) patient, and was abnormal (<500/mm 3 ) in 5 (83.3%) patients (χ 2 =5.3, P =0.021).…”

Section: Resultsmentioning

confidence: 99%

“…The search identified 31 relevant studies from 2000 to 2013 [ 7 , 9 - 38 ] , including 24 case reports [ 7 , 9 , 10 , 12 , 13 , 15 , 17 - 22 , 24 - 28 , 30 - 33 , 36 - 38 ] , 2 case series [ 14 , 23 ] , 2 original articles [ 11 , 34 ] , 1 medical imaging [ 16 ] , 1 poster abstract session [ 29 ] , and 1 "letter to the editor" [ 35 ] . After reviewing selected articles, all 31 articles were included and no one was excluded.…”

Section: Methodsmentioning

confidence: 99%

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Mycobacterial endocarditis: a comprehensive review

Yuan¹

2014

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveA systematic analysis was made in view of the epidemiology, clinical features, diagnosis, treatment and main outcomes of mycobacterial endocarditis.MethodsThe data source of the present study was based on a comprehensive literature search in MEDLINE, Highwire Press and Google search engine for publications on mycobacterial endocarditis published between 2000 and 2013.ResultsThe rapidly growing mycobacteria become the predominant pathogens with Mycobacterium chelonae being the most common. This condition has changed significantly in terms of epidemiology since the 21st century, with more broad patient age range, longer latency, prevailed mitral valve infections and better prognosis.ConclusionMycobacterial endocarditis is rare and the causative pathogens are predominantly the rapidly growing mycobacteria. Amikacin, ciprofloxacin and clarithromycin are the most frequently used targeted antimicrobial agents but often show poor responses. Patients with deep infections may warrant a surgical operation or line withdrawal. With periodic multidrug therapy guided by drug susceptibility testing, and surgical managements, patients may achieve good therapeutic results.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Mycobacterial endocarditis: a comprehensive review

Yuan¹

2014

Revista Brasileira De Cirurgia Cardiovascular

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Biofilms of the non-tuberculous Mycobacterium chelonae form an extracellular matrix and display distinct expression patterns

et al. 2020

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Mycobacterium chelonae is an environmental, non-tuberculous mycobacterial species, capable of causing infections in humans. Biofilm formation is a key strategy used by M. chelonae in colonising niches in the environment and in the host. We studied a water-air interface (pellicle) biofilm of M. chelonae using a wide array of approaches to outline the molecular structure and composition of the biofilm. Scanning electron micrographs showed that M. chelonae biofilms produced an extracellular matrix. Using a combination of biochemical analysis, Raman spectroscopy, and fluorescence microscopy, we showed the matrix to consist of proteins, carbohydrates, lipids and eDNA. Glucose was the predominant sugar present in the biofilm matrix, and its relative abundance decreased in late (established) biofilms. RNA-seq analysis of the biofilms showed upregulation of genes involved in redox metabolism. Additionally, genes involved in mycolic acid, other lipid and glyoxylate metabolism were also upregulated in the early biofilms.

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Mycobacterial Endocarditis, A Rare Form of Infective Endocarditis

Dawi,

Affa,

Chorbajian

et al. 2024

Discovery Medicine

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This research project delves into the multifaceted dynamics of Mycobacterium tuberculosis (M.tb) endocarditis, a significant yet uncommon manifestation of tuberculosis (TB). Beginning with an overview of M.tb and the global challenges posed by TB, we navigate through the bacterium's evolution, transmission modes, and the intricate host immune response. The pathology and pathophysiology of M.tb endocarditis are explored, emphasizing its complexities and the host's efforts to contain the pathogen. The study extends to atypical mycobacterial endocarditis, highlighting the emergence of species like M.chimaera, M.fortuitum, and M.chelonae, with a focus on their association with life-threatening mycobacterial endocarditis. Clinical presentations and complications of M.tb endocarditis are detailed, addressing challenges in diagnosis, drug-resistant, co-infections with Human Immunodeficiency Virus (HIV), and potential sepsis. The research underscores the need for a deeper understanding of M.tb endocarditis to enhance prevention, diagnosis, and treatment strategies. Examining the genetic and environmental factors influencing M.tb endocarditis, the study discusses the interplay of immune-related genes, environmental conditions, and predispositions contributing to infection susceptibility. Despite challenges in treatment due to its rarity, the research highlights current protocols, surgical interventions, and promising pharmaceutical developments. Lastly, unraveling these intricate factors is crucial for refining strategies and conducting large-scale trials to address this global health threat effectively.

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Spontaneous endocarditis caused by rapidly growing non-tuberculous Mycobacterium chelonae in an immunocompetent patient with rheumatic heart disease

Cited by 6 publications

References 6 publications

Mycobacterial endocarditis: a comprehensive review

Mycobacterial endocarditis: a comprehensive review

Biofilms of the non-tuberculous Mycobacterium chelonae form an extracellular matrix and display distinct expression patterns

Mycobacterial Endocarditis, A Rare Form of Infective Endocarditis

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