Staphylococcus lugdunensis Endocarditis in a Patient Being Treated for Pyelonephritis

Year 2018, Volume: 08 Issue: 01, 37 - 40, 15.03.2018

Christopher M Peake Nicholas Faure-walker Elli Demertzi

https://doi.org/10.5799/jmid.404245

Abstract

Staphylococcus lugdunensis
Endocarditis in a Patient Being Treated for Pyelonephritis

Christopher
M Peake¹, Nicholas Faure-Walker², Elli DeMertzi²

¹St George’s University Hospital,
Blackshaw Road, Tooting, London, UK

²Kingston Hospital, Galsworthy Road,
Kingston-upon-Thames, UK

 

ABSTRACT

A 35
years old female with known chronic left pelvo-ureteric junction (PUJ)
obstruction presented with recurrent pyrexia and left loin pain and was treated
for pyelonephritis. She had a history of severe aortic valve (AV)
regurgitation. After five days of broad spectrum antibiotics and a percutaneous
nephrostomy, her fevers persisted. Staphylococcus
lugdunensis was isolated from her blood culture and she was diagnosed with
mitral valve endocarditis following an echocardiogram. She was transferred to a
tertiary cardiothoracic unit where she underwent a mitral and aortic mechanical
valve repair. After 6 weeks of intravenous antibiotic treatment she was
discharged without signs of infection but with poor cardiac function. S. lugdunensis is a virulent organism
which is thought to be underdiagnosed and is associated with aggressive and
destructive endocarditis. An awareness of the organism as well as prompt
diagnosis and treatment with effective multi-disciplinary management is needed
to avoid substantial morbidity in these patients.

Whilst
S. lugdunensis is known to cause
invasive endocarditis, it has never been reported following pyelonephritis. The
significance of this case is that despite receiving appropriate and timely
treatment the patient was left with deteriorating cardiac function. This is an
important reminder that this organism must be taken seriously when isolated in
the context of infection. J Microbiol
Infect Dis 2018; 8(1):37-40

Keywords: Staphylococcus lugdunensis, endocarditis,
pyelonephritis, heart valves, urinary tract

Keywords

Staphylococcus lugdunensis, endocarditis, pyelonephritis, heart valves, urinary tract

References

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