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CASE REPORT
Infectious endocarditis and vertebral osteomyelitis caused by Moraxella catarrhalis
  1. Serban M Maierean1,
  2. Daniel C Marinescu2,
  3. David O Croitoru3 and
  4. Amol A Verma2,4
  1. 1 Department of Medicine, Universitatea de Medicina si Farmacie Victor Babes din Timisoara, Timisoara, Timis, Romania
  2. 2 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Medicine, Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
  4. 4 Department of Medicine, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
  1. Correspondence to Dr Amol A Verma, amol.verma{at}mail.utoronto.ca

Abstract

Moraxella catarrhalis frequently colonises the oropharynges of healthy individuals. Disease is usually limited to the oropharynx, upper airways and lower airways in patients with predisposing conditions. The pathogen rarely causes more invasive disease. We present the case of a 65-year-old woman with Crohn’s disease on azathioprine, who was diagnosed with native valve M. catarrhalis endocarditis and vertebral osteomyelitis several weeks after an upper respiratory tract infection. She presented to hospital with 5 weeks of worsening malaise, nausea, relapsing fevers, weight loss, acute-on-chronic exacerbation of lower back pain and diffuse myalgia. Transoesophageal echocardiogram showed a 12 mm vegetation on her mitral valve, contrast-enhanced MRI was consistent with L4 osteomyelitis and blood cultures were persistently positive for M. catarrhalis. She was initially treated with ceftriaxone 2 g intravenously daily, and although her symptoms initially resolved, she experienced a relapse of osteomyelitis with L3 extension a few weeks after treatment discontinuation.

  • valvar diseases
  • bone and joint infections
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Footnotes

  • Contributors SMM and DCM: acquisition, analysis and interpretation of data for the work and drafting the work. DOC: analysis and interpretation of data for the work and revising the paper critically for important intellectual content. AAV: analysis and interpretation of data for the work, revising the paper critically for important intellectual content and final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Patient consent for publication Obtained.

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