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Gemella morbillorum mitral valve endocarditis in a patient with a history of mitral valve annuloplasty
  1. Charles Ruohua Liu1,
  2. Christopher A Heid2,
  3. Raghav Chandra3,
  4. Edward Hauptmann1,
  5. Mary Elizabeth Brickner1,
  6. Michael Hwang1 and
  7. Michael A Wait2
  1. 1School of Medicine, UT Southwestern, Dallas, Texas, USA
  2. 2Department of Cardiovascular and Thoracic Surgery, UT Southwestern, Dallas, Texas, USA
  3. 3Department of Surgery, UT Southwestern, Dallas, Texas, USA
  1. Correspondence to Mr Charles Ruohua Liu; charles.liu{at}


A woman with a history of congenital heart disease status post multiple valve operations including mitral valve repair presented with 2 months of low back pain and general malaise. Blood cultures returned positive for Gram-positive cocci. While transthoracic echocardiography did not identify vegetations, transoesophageal echocardiography visualised vegetations on the patient’s mitral valve, which had previously undergone repair with annuloplasty. The patient was found to have infectious endocarditis (IE), caused by Gemella morbillorum. The patient was treated with over 6 weeks of intravenous antibiotics. Cases of Gemella-associated IE are rare and largely relegated to case reports. This report aims to contribute to the literature regarding this subject, and to further characterise the presentation and treatment of Gemella-associated IE. Additionally, this report emphasises the importance of maintaining a high suspicion of IE in a patient with non-specific malaise in the setting of prior cardiac valve operation.

  • Valvar diseases
  • Infectious diseases

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  • Contributors CRL conceptualised the case report, participated in the patient’s care, and wrote and edited the manuscript. CAH, RC and EH contributed to conceptualising, writing and editing the manuscript. MEB participated in the patient’s care, reviewed and labelled the patient’s transoesophageal echocardiogram, and reviewed and edited the manuscript. MH provided care for the patient, obtained the patient’s consent for the case report, and reviewed and edited the manuscript. MAW was involved in the patient’s prior surgery, provided literature which was included in the report, and reviewed and edited the manuscript.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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