Infective Endocarditis Caused by Finegoldia magna Following Aortic Dissection Repair: A Case Report and Data Evaluation
Unusual clinical course, Challenging differential diagnosis, Unusual setting of medical care, Patient complains / malpractice, Educational Purpose (only if useful for a systematic review or synthesis)
Khetam Hussein, Ziv Savin, Liran Shani, Yaakov Dickstein, Yuval Geffen, Ayelet Raz-Pasteur
Infectious Disease Unit, Rambam Health Care Campus, Haifa, Israel
Am J Case Rep 2014; 15:554-558
Finegoldia magna (F. magna) is a rare pathogen causing infective endocarditis (IE). Only 7 cases are documented in the literature.
Case Report: We report a case of infective endocarditis in a 45-year-old male due to F. magna 2 months after a Bentall procedure. He presented with fever, dyspnea, and chest pain. Aerobic and anaerobic blood samples were drawn before empirical antibiotic treatment was initiated. A transesophageal echocardiogram (TEE) demonstrated several findings involving the prosthetic valve, including a vegetation. The patient underwent a second aortic repair procedure. Tissue cultures obtained from 2 sources in the infected area during the operation were positive for F. magna. The antibiotic regimen was changed in accordance with susceptibility testing to piperacillin/tazobactam. Two weeks after the operation, the patient was released with a recommendation for antibiotic treatment for 8 weeks.
Conclusions: We report this case because F. magna in a rare pathogen causing endocarditis. This was a case of prosthetic valve F. magna IE in which the definitive diagnosis was based on tissue cultures following sterile blood cultures. Data evaluation of all F. magna IE reported cases illustrated that tissue cultures were the predominant microbiologic diagnostic tool used.
Keywords: Aortic Aneurysm - surgery, Aneurysm, Dissecting - surgery, Aortic Valve, Endocarditis, Bacterial - therapy, Gram-Positive Bacterial Infections - therapy, Heart Valve Prosthesis - adverse effects, Peptostreptococcus, Prosthesis-Related Infections - therapy