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Multi-valvular infective endocarditis from Gemella morbillorum
  1. Anish Kumar Desai1 and
  2. Erin Murchan Bonura2
  1. 1Internal Medicine, Oregon Health & Science University, Portland, Oregon, USA
  2. 2Infectious Diseases, Oregon Health & Science University, Portland, Oregon, USA
  1. Correspondence to Dr Erin Murchan Bonura; bonura{at}ohsu.edu

Abstract

Gemella morbillorum is increasingly implicated in infectious endocarditis. Our patient presented with anaemia and renal failure with evidence of infarcts and embolic disease. He was found to have endocarditis with an organism that could not speciate with standard culture methods requiring matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) for identification and susceptibilities. While involvement of mitral and aortic valves can be expected with Gemella, he had rare involvement of the pulmonic valve in a structurally normal heart. Although bacteriological cure was achieved, due to the locally destructive nature of Gemella, he ultimately required valve replacements for heart failure resolution. Workup for commonly implicated pathologies associated with G. morbillorum led to suspicion of gastrointestinal malignancy with findings of occult bleeding prompting an ongoing evaluation. With improved access to advanced diagnostics, G. morbillorum has been increasingly identified in infectious endocarditis. Given its destructive nature, it is important for clinicians to consider this organism is difficult to identify isolates.

  • heart failure
  • valvar diseases
  • infectious diseases
  • medical management
  • drugs: infectious diseases

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Footnotes

  • Twitter @AnishDesai15

  • Contributors Substantial contributions by both AKD and EMMB. Literature search and review, manuscript planned and composed by AKD with significant edits contributed by EMMB, the senior author who was part of the patient’s original treatment team. Idea for the article was composed by EMMB.

  • 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.

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