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Staphylococcus lugdunensis pulmonary valve endocarditis in a patient on chronic hemodialysis. Am J Nephrol 1999;19(5):605-8

Date

11/27/1999

Pubmed ID

10575192

DOI

10.1159/000013528

Scopus ID

2-s2.0-0032700784   20 Citations

Abstract

We describe a case of Staphylococcus lugdunensis pulmonary valve endocarditis in a 65-year-old woman on chronic hemodialysis and provide a review of previously reported cases. The patient presented with fever and altered mental status, but had no other localizing symptoms or signs; coagulase-negative staphylococcus (subsequently identified as S. lugdunensis) was isolated from two sets of blood cultures. Transthoracic and transesophageal echocardiograms showed a large (2.3 x 3.1 cm) vegetation on the pulmonary valve with moderate valvular insufficiency. The patient was treated with 6 weeks of antibiotic therapy and is stable 4 months following the completion of therapy; no surgical intervention was performed. Of the 28 previously reported cases of S. lugdunensis endocarditis, only 1 had previously survived with medical therapy alone. This is the 3rd case report of S. lugdunensis endocarditis in a patient on hemodialysis; the presumed portal of entry in this and previously reported cases was the vascular access device. Endocarditis due to this organism is characterized by a high mortality, rapid tissue destruction, and a predilection for native valves. Because the clinical outcome is much more favorable with valvular replacement, speciation of the organism assumes great importance in defining the therapeutic approach.

Author List

Kamaraju S, Nelson K, Williams DN, Ayenew W, Modi KS

Author

Sailaja Kamaraju MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Anti-Bacterial Agents
Drug Therapy, Combination
Echocardiography, Transesophageal
Endocarditis, Bacterial
Female
Heart Valve Diseases
Humans
Injections, Intravenous
Kidney Failure, Chronic
Pulmonary Valve
Renal Dialysis
Staphylococcal Infections
Staphylococcus
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0