RESUMEN
A previously healthy 27-year-old Jamaican man presented to the University Hospital of the West Indies with recurrent joint pain, remitting and relapsing fever, and shortness of breath. He was subsequently found to have Abiotrophia defectiva endocarditis. This was the first time this organism had been isolated at our institution. Despite culture directed antibiotics, his clinical course was quite severe with mitral regurgitation and congestive cardiac failure requiring mitral valve replacement. He recovered well postoperatively and is currently being followed at our outpatient cardiology clinic. This report highlights the severe presentation and often poor outcome associated with A. defectiva endocarditis and stresses that the outcome may be improved by early and appropriate surgical intervention.
Asunto(s)
Abiotrophia , Endocarditis Bacteriana/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Insuficiencia de la Válvula Mitral/microbiología , Válvula Mitral/microbiología , Adulto , Antibacterianos/uso terapéutico , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/patología , Infecciones por Bacterias Grampositivas/complicaciones , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/patología , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/microbiología , Insuficiencia Cardíaca/cirugía , Implantación de Prótesis de Válvulas Cardíacas , Humanos , Masculino , Válvula Mitral/patología , Válvula Mitral/cirugía , Insuficiencia de la Válvula Mitral/etiología , Insuficiencia de la Válvula Mitral/cirugíaRESUMEN
Dengue fever is an important public health problem in Jamaica and has various serious manifestations, which if not identified and treated at the appropriate time can lead to dire consequences. Bacterial co-infections have been seen in clinical practice but may be thought of as simply coincidental. This review highlights the importance of bacteria in exacerbating dengue infections and the importance of looking for co-infection in patients with certain clinical manifestations. It also provides the reader with a scientific understanding of the immune pathogenesis of dengue and bacterial co-infections.
Asunto(s)
Anticuerpos Antivirales/sangre , Virus del Dengue/inmunología , Dengue/complicaciones , Neumonía/complicaciones , Staphylococcus aureus , Adolescente , Antibacterianos/uso terapéutico , Coinfección , Dengue/sangre , Dengue/terapia , Humanos , Masculino , Neumonía/tratamiento farmacológico , Neumonía/microbiologíaRESUMEN
The authors report a fatal case of Corynebacterium sp. endocarditis. Corynebacterium spp. are non-sporulating, pleomorphic Gram-positive bacilli. In particular the authors have identified a species of Corynebacterium very closely related to C striatum. This is C simulans. The authors were able to identify the genus and species using various phenotypic tests. Highlighted here is the importance of identifying diphtheroids as a significant pathogen in the appropriate setting and the need to start antibiotic therapy if this is suspected.
