STAPHYLOCOCCUS LUGDUNENSIS’E BAĞLI DESTRÜKTİF SAĞ KAPAK ENDOKARDİTİ

Year 2022, Volume: 36 Issue: 1, 34 - 37, 30.04.2022

Ali Ilgın Olut , Alpay Arı , Ufuk Sönmez , Funda Balaylar Deniz Yüce Yıldırım Hilal Baş , İbrahim Uyar

https://doi.org/10.54962/ankemderg.1107869

Abstract

Koagülaz negatif stafilokok (KNS) grubunun bir üyesi olan Staphylococcus lugdunensis, normal cilt florası olarak insanların %30 ila %50'sinde çoğunlukla kasık bölgesi, koltuk altı ve burun deliklerinde olmak üzere kolonize olur. Patojen olarak ilk tanımlandığı 1988 yılından bu yana, giderek artan sayıda ve geniş bir yelpazede bulaşıcı hastalıkların bir nedeni olarak rapor edilmiştir. Bunlar yumuşak doku, kemik, eklem, idrar yolu enfeksiyonları ve çoğunlukla doğal sol kalp kapakçıklarını tutan, apse oluşumu, hızlı kapak yıkımı, yüksek emboli oranı ve çoğu durumda kapak değiştirme operasyonu gerekliliği ile karakterize agresif bir enfektif endokardit (EE) formu olarak klinikte karşımıza çıkar. Bu çalışmada kronik böbrek yetmezliği öyküsü olan bir erkek hastada hem triküspit hem de pulmoner kalp kapakçıklarını tutan S. lugdunensis'e bağlı şiddetli destrüktif EE olgusu sunulmaktadır. Hastada daptomisin artı klindamisin tedavisinin 42. gününde kapak replasmanı operasyonuna ihtiyaç duyulmuş ve ilk tanısından 58 gün sonra şifa ile taburcu edilmiştir.

Keywords

enfektif endokardit, Staphylococcus lugdunensis, triküspit ve pulmoner kalp kapakçıkları

Destructive Right Valve Endocarditis due to Staphylococcus lugdunensis

Abstract

Staphylococcus lugdunensis, a member of the coagulase-negative staphylococci (CNS) group, colonizes as normal skin flora in 30% to 50% of people, mostly in the groin area, axillae and nostrils. Since 1988, when it was first identified as a pathogen, it has been reported as a cause of an increasing number and wide range of infections such as soft tissue, bone, joint, urinary tract infections, and an aggressive form of infective endocarditis (IE), mostly involving the native left heart valves, characterized by abscess formation, rapid valve destruction, high embolism rate and in most of the cases, the necessity of valve replacement operation. In this study, a case of severe destructive IE due to S.lugdunensis involving both tricuspid and pulmonary heart valves in a male patient with a history of chronic renal failure is presented. A valve replacement operation is needed on the 42nd day of daptomycin plus clindamycin treatment, and the patient was discharged with healing 58 days after diagnosis.

Keywords

infective endocarditis, Staphylococcus lugdunensis, tricuspid and pulmonary heart valves

References

• Anguera I, Del Río A, Miró JM, et al. Staphylococcus lugdunensis infective endocarditis: description of 10 cases and analysis of native valve, prosthetic valve, and pacemaker lead endocarditis clinical profiles. Heart. 2005;91(2):e10.
• Argemi X, Hansmann Y, Riegel P, Prévost G. Is Staphylococcus lugdunensis significant in clinical samples? J Clin Microbiol. 2017;55(11):3167-74.
• Çelebi G, Büyükateş M, Doğan SM, et al. Staphylococcus lugdunensis’e bağlı nekrotizan mitral kapak endokarditi. Mikrobiyol Bul 2009;43(2):319-23.
• Fernández Guerrero ML, Álvarez B, Manzarbeitia F, Renedo G. Infective endocarditis at autopsy: a review of pathologic manifestations and clinical correlates. Medicine (Baltimore). 2012;91(3):152-64.
• Freney J, Brun Y, Bes M, et al. Staphylococcus lugdunensis sp. nov. and Staphylococcus schleiferi sp. nov., two species from human clinical specimens. Int J Syst Evol Microbiol. 1988;38(3):168-72.
• Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart . 2015;36(44):3075-128.
• Haile DT, Hughes J, Vetter E, et al. Frequency of isolation of Staphylococcus lugdunensis in consecutive urine cultures and relationship to urinary tract infection. J Clin Microbiol. 2002;40(2):654-6. doi:10.1128/JCM.40.2.654-656.2002
• Heldt Manica LA, Cohen PR. Staphylococcus lugdunensis infections of the skin and soft tissue: a case series and review. Dermatol Ther. 2017;7(4):555-62. doi: 10.1007/s13555-017-0202-5
• Karnani R, Myers JP. Bone and joint infections caused by Staphylococcus lugdunensis: report of 2 cases and review of the literature. Infect Dis Clin Pract. 2008;16(4):94-9.
• Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30(4):633-8.
• Liu PY, Huang YF, Tang CW, et al. Staphylococcus lugdunensis infective endocarditis: a literature review and analysis of risk factors. J Microbiol Immunol Infect. 2009;43(6):478-84.
• Pacei F, Bet L. Spinal epidural abscess as a complication of cardiosurgery. Neurol Sci. 2014;35(5):805-7. doi: 10.1007/s10072-014-1670-3
• Parthasarathy S, Shah S, Raja Sager A, Rangan A, Durugu S. Staphylococcus lugdunensis: review of epidemiology, complications, and treatment. Cureus. 2020;12(6):e8801.
• Vahabi A, Gül F, Garakhanova S, Sipahi H, Sipahi OR. Pooled analysis of 1270 infective endocarditis cases in Turkey. J Infect Dev Ctries. 2019;28(13):93-100.