TY - JOUR T1 - <em>Neisseria elongata</em> subsp <em>elongata</em> infective endocarditis following endurance exercise JF - BMJ Case Reports DO - 10.1136/bcr-2015-212415 VL - 2015 SP - bcr2015212415 AU - Joanne May Jenkins AU - Amanda Fife AU - Max Baghai AU - Rafal Dworakowski Y1 - 2015/12/11 UR - http://casereports.bmj.com/content/2015/bcr-2015-212415.abstract N2 - A 31-year-old Argentinian woman presented with a 3-week history of fever, night sweats, myalgia and lethargy following a work trip to Uganda where she ran a marathon. Malarial screens were negative but C reactive protein, erythrocyte sedimentation rate and neutrophil count were raised and she was anaemic. A new pansystolic murmur was heard over the mitral valve and the transthoracic echocardiogram showed a large vegetation (&gt;1 cm) with at least moderate mitral regurgitation. Blood cultures grew Neisseria elongata, subsp elongata treated initially with ceftriaxone then oral ciprofloxacin to complete 4 weeks of treatment. CT scan revealed a wedge-shaped area of low attenuation in the spleen in keeping with a splenic infarct. Seven days postadmission, the patient underwent a successful mitral valve repair. Recovery was complicated by a likely embolic infarct in the right frontal lobe, but the patient was discharged 12 days postoperative with no neurological sequelae. ER -