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Minerva Anestesiologica 2012 June;78(6):729-32

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Treatment with daptomycin for Corynebacterium jeikeium left-sided prosthetic valve endocarditis

Lappa A. ¹, Donfrancesco S. ¹, Picozzi P. ¹, Vitozzi T. ¹, Marrapodi A. ¹, Menichetti A. ¹, Casali G. ², Musumeci F. ² ✉

¹ Departments of Cardiovascular Anesthesia and Intensive Care, San Camillo-Forlanini Hospital, Rome, Italy; ² Cardiac Surgery and Heart Transplantation, San Camillo-Forlanini Hospital, Rome, Italy

Prosthetic valve endocarditis (PVE) is a serious complication with potential fatal consequences, classified as early or late PVE, depending on whether typical symptoms occur within or later than 12 months from surgery. The incidence of early PVE is under 1%, but it carries high morbidity and mortality rates. There are few reported cases in literature of PVE due to Corynebacterium jeikeium even though it is present in normal skin flora particularly in hospitalized patients. Corynebacterium species are, in fact, recognized as uncommon agents of endocarditis and little is known regarding species-specific risk factors and the outcome in this kind of endocarditis. Described is an unusual case report of a 57-year-old man who had early aortic PVE due to Corynebacterium Jeikeium infection complicated by dehiscence of the prosthesis, complete atrio-ventricular block, perforation of the interventricular septum and septic shock. Prompt diagnosis, choice of daptomycin as antibiotic therapy although it has only been approved by the European Medicine Agency (EMEA) for right-sided endocarditis and timely open heart surgery, resulted in a successful outcome.