The first report of survival post Rothia aeria endocarditis.
Journal: 2014/May - BMJ Case Reports
ISSN: 1757-790X
Abstract:
A 61-year-old patient presented with drowsiness, decreased appetite and weight loss. On examination he had several splinter haemorrhages and a tender mass over the right temporal region. Respiratory and abdominal examinations were unremarkable and heart sounds were normal with no clinically audible murmurs. He spiked regular temperatures and consequently had several blood cultures taken. Transthoracic and transoeseophageal echocardiogram showed a 3 cm mitral valve vegetation. MRI confirmed suspicions of septic emboli in the brain. Blood cultures grew Rothia aeria and he was started on benzylpenicillin, rifampicin and gentamicin. After a period of observation he deteriorated clinically and biochemically, surgical intervention therefore ensued with an urgent metallic mitral valve replacement. Nineteen days postsurgery the patient was successfully discharged on outpatient antibiotic therapy and warfarin. In view of complications such as embolisation and cerebral infarction, R aeria endocarditis should be managed aggressively and with a high index of clinical suspicion.
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BMJ Case Rep 2013: bcr2013200534

The first report of survival post <em>Rothia aeria</em> endocarditis

Department of Primary Care, Imperial College Healthcare NHS Trust, London, UK
Barnet and Chase Farm Hospitals NHS Trust, London, Hertfordshire, UK
Division of Medicine, Imperial College London, London, UK
Department of Medical Microbiology, Imperial College Healthcare NHS Trust, London, UK
Dr Arun Thiyagarajan, moc.liamg@50najar.nura
Dr Arun Thiyagarajan, moc.liamg@50najar.nura

Abstract

A 61-year-old patient presented with drowsiness, decreased appetite and weight loss. On examination he had several splinter haemorrhages and a tender mass over the right temporal region. Respiratory and abdominal examinations were unremarkable and heart sounds were normal with no clinically audible murmurs. He spiked regular temperatures and consequently had several blood cultures taken. Transthoracic and transoeseophageal echocardiogram showed a 3 cm mitral valve vegetation. MRI confirmed suspicions of septic emboli in the brain. Blood cultures grew Rothia aeria and he was started on benzylpenicillin, rifampicin and gentamicin. After a period of observation he deteriorated clinically and biochemically, surgical intervention therefore ensued with an urgent metallic mitral valve replacement. Nineteen days postsurgery the patient was successfully discharged on outpatient antibiotic therapy and warfarin. In view of complications such as embolisation and cerebral infarction, R aeria endocarditis should be managed aggressively and with a high index of clinical suspicion.

Abstract
Learning points

Acknowledgments

Dr Claire Thomas, Department of Microbiology, Imperial College NHS Trust, London, UK.

Acknowledgments

Footnotes

Contributors: AT and AB wrote the manuscript. DH collected and summarised all information and data. JH provided feedback, guidance, critical review and was involved in revision of the manuscript.

Competing interests: None.

Patient consent: Obtained.

Provenance and peer review: Not commissioned; externally peer reviewed.

Footnotes

References

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