%0 Journal Article
%T Infective Endocarditis: A Rare Organism in an Uncommon Setting
%A Rajiv Ananthakrishna
%A Ravindranath K. Shankarappa
%A Naveena Jagadeesan
%A Ravi S. Math
%A Satish Karur
%A Manjunath C. Nanjappa
%J Case Reports in Infectious Diseases
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/307852
%X Facklamia hominis is a rare causative organism of infective endocarditis (IE). Only few cases of infection due to F. hominis have been reported in the literature. We describe a case of IE due to Gram-positive, alpha-haemolytic, catalase-negative coccus F. hominis in an adult patient with rheumatic mitral stenosis. Isolated mitral stenosis is an uncommon valve lesion predisposing to IE. The following paper is being presented to emphasize the possibility of IE due to F. hominis, and laboratories need to be alert of the potential significance in appropriate clinical setting. 1. Introduction Infective endocarditis (IE) is one of the major complications in individuals with structural heart disease. The majority of cases of IE are caused by Streptococci, Staphylococci, Enterococci, and fastidious Gram-negative coccobacilli. In their absence, unusual organisms should be considered. Facklamia hominis is one such rare organism [1]. Facklamia species are Gram-positive, alpha-haemolytic, catalase negative cocci, which resemble Streptococcus viridians on 5% sheep blood agar. Only few cases of infection due to F. hominis have been reported in the literature. We present a case of IE due F. hominis in an adult patient with rheumatic mitral stenosis. Isolated mitral stenosis is an uncommon valve lesion predisposing to IE. The following paper is being presented to emphasize the possibility of IE due to F. hominis, and laboratories need to be alert of the potential significance in appropriate clinical setting. 2. Case Report A 35-year-old male with rheumatic heart disease was admitted to our hospital for evaluation of fever of 3-weeks duration. He had been empirically treated for enteric fever by a primary care physician. The patient had received oral ciprofloxacin for 1 week prior to admission. He was on regular benzathine penicillin prophylaxis and had undergone balloon mitral valvotomy 15 years earlier. The temperature at presentation was 101¡ãF. The patient was hemodynamically stable. Cardiovascular system examination revealed a middiastolic murmur at the apex. The rest of the systemic examination was unremarkable. Three separate sets of blood cultures were obtained for possible IE. Blood cultures were performed using BacT/ALERTR FA bottles (Biomerieux). These bottles were incubated in the Bact/ALERT microbial detection system. Pending culture reports, empirical intravenous treatment with crystalline penicillin (24£¿million units/24£¿hr IV, every 4£¿hr in six equally divided doses) and gentamicin (1£¿mg/kg IV every 8£¿hr) was initiated. Results routine blood tests were:
%U http://www.hindawi.com/journals/criid/2012/307852/