BACKGROUND: We report the case of a 35-year-old man with stroke related to infective endocarditis (IE) caused by Kocuria kristinae. CASE DESCRIPTION: The patient with chronic hepatitis C virus infection and a former intravenous drug user developed a stroke suddenly, after three months duration of fever and malaise. Duplex ultrasonography of the carotid arteries (zero level diastolic flow, diastolic reversed flow) focused attention to cardiac valve pathology and endocarditis (definite confirmation was made by transesophageal echocardiography). Kocuria kristinae was grown from the blood culture and antibiotic therapy administered, according to the antibiogram, did not cure the infection and the patient underwent an aortic valve replacement with a mechanical prosthesis and debridement of the mitral valve. One year after the surgery, the patient had no subjective problems and neurological findings were normal. Conclusion: To our knowledge, this is the first case of IE caused by Kocuria kristinae, which was diagnosed after the development of stroke, where IE was suspected based on Duplex ultrasonography of the carotid arteries. This is the second case of infection by this bacterium which could not be cured by antibiotics only and had to be submitted to surgical intervention. Hippokratia 2016, 20(3): 231-234.
BACKGROUND: We report the case of a 35-year-old man with stroke related to infective endocarditis (IE) caused by Kocuria kristinae. CASE DESCRIPTION: The patient with chronic hepatitis C virus infection and a former intravenous drug user developed a stroke suddenly, after three months duration of fever and malaise. Duplex ultrasonography of the carotid arteries (zero level diastolic flow, diastolic reversed flow) focused attention to cardiac valve pathology and endocarditis (definite confirmation was made by transesophageal echocardiography). Kocuria kristinae was grown from the blood culture and antibiotic therapy administered, according to the antibiogram, did not cure the infection and the patient underwent an aortic valve replacement with a mechanical prosthesis and debridement of the mitral valve. One year after the surgery, the patient had no subjective problems and neurological findings were normal. Conclusion: To our knowledge, this is the first case of IE caused by Kocuria kristinae, which was diagnosed after the development of stroke, where IE was suspected based on Duplex ultrasonography of the carotid arteries. This is the second case of infection by this bacterium which could not be cured by antibiotics only and had to be submitted to surgical intervention. Hippokratia 2016, 20(3): 231-234.
Authors: Dieter Horstkotte; Ferenc Follath; Erno Gutschik; Maria Lengyel; Ali Oto; Alain Pavie; Jordi Soler-Soler; Gaetano Thiene; Alexander von Graevenitz; Silvia G Priori; Maria Angeles Alonso Garcia; Jean-Jacques Blanc; Andrzej Budaj; Martin Cowie; Veronica Dean; Jaap Deckers; Enrique Fernández Burgos; John Lekakis; Bertil Lindahl; Gianfranco Mazzotta; João Morais; Ali Oto; Otto A Smiseth; John Lekakis; Alec Vahanian; François Delahaye; Alexander Parkhomenko; Gerasimos Filipatos; Jan Aldershvile; Panos Vardas Journal: Eur Heart J Date: 2004-02 Impact factor: 29.983
Authors: C C Lai; J Y Wang; S H Lin; C K Tan; C Y Wang; C H Liao; C H Chou; Y T Huang; H I Lin; P R Hsueh Journal: Clin Microbiol Infect Date: 2011-02 Impact factor: 8.067