Infect Chemother.  2016 Sep;48(3):229-233. 10.3947/ic.2016.48.3.229.

A Case of Infective Endocarditis caused by Abiotrophia defectiva in Korea

• Park S
• Ann HW
• Ahn JY
• Ku NS
• Han SH
• Hong GR
• Choi JY
• Song YG
• Kim JM

• KMID: 2466438
• DOI: http://doi.org/10.3947/ic.2016.48.3.229

Abstract

Abiotrophia defectiva, a nutritionally variant streptococci can cause bacteremia, brain abscess, septic arthritis and in rare cases, infective endocarditis, which accounts for 5-6% of all cases. A. defectiva is characteristically difficult to diagnose and the mortality, morbidity and complication rates are high. Here, we discuss a case of infective endocarditis caused by A. defectiva. A 62-year-old female had previously undergone prosthetic valve replacement 6 years prior to admission. She developed infective endocarditis after tooth extraction. Her endocarditis was successfully treated with antimicrobial therapy and mitral valve replacement surgery. This is the first case of infective endocarditis caused by A. defectiva reported in Korea. This case shows that A. defectiva could be considered as a causative organism of infective endocarditis in Korea.

Keyword

Abiotrophia defectiva; infective endocarditis

MeSH Terms

Abiotrophia*
Arthritis, Infectious
Bacteremia
Brain Abscess
Endocarditis*
Female
Humans
Korea*
Middle Aged
Mitral Valve
Mortality
Tooth Extraction

Figure

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  Figure 1 Transesophageal echocardiography performed the day after admission. (A) Long-axis view (135°) of a transesophageal echocardiography showing two examples of vegetation attached to the prosthetic mitral valve. The larger one measures 0.7 ☓ 0.5 cm (large arrow head) and the smaller one measures 0.5 ☓ 0.3 cm (small arrow head). (B) Two-chamber view (59°) of a transesophageal echocardiography (zoomed view) showing vegetation attached to the prosthetic mitral valve (arrowhead). A color Doppler shows the jet flow with mild transvalvular mitral regurgitation in systole (arrow). LA, left atrium; LV, left ventricle; RV, right ventricle.

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  Figure 2 Colony and microscopic characteristics of Abiotrophia defective. Tiny, non-hemolytic colonies on a blood agar plate (ASAN Pharmaceutical, Hwaseong, Korea) after 48 hour of incubation at 35°C with 5% CO2 (left), and pleomorphic Gram-positive cocci from smear preparation of the blood agar plate (Gram stain, ×1,000, right).

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