RESUMEN
PURPOSE: A case report of the use of linezolid and daptomycin for the treatment of multidrug-resistant right-sided infective endocarditis is presented. SUMMARY: A 36-year-old patient with a history of intravenous drug use was hospitalized for treatment of native tricuspid valve endocarditis resulting in persistent methicillin-resistant Staphylococcus aureus bacteremia. During the admission the patient was unsuccessfully treated with vancomycin monotherapy (final E-test minimum inhibitory concentration, 4 µg/mL). The patient's treatment was switched to daptomycin and gentamicin, with no improvement in blood culture results over 4 days. Gentamicin was discontinued, and linezolid was administered in combination with daptomycin; bacteremia was cleared after 13 days of linezolid and daptomycin combination therapy. Due to daptomycin resistance (minimum inhibitory concentration, 4 µg/mL), gentamicin was substituted for daptomycin due to the former agent's synergistic effects with linezolid. After 23 days of therapy the patient was transferred to another facility for a tricuspid valve replacement procedure, which was completed without complications. The patient was transferred in stable condition to a skilled nursing facility to continue antibiotic therapy lasting 6 weeks from the date of surgery. The patient's blood cultures remained negative. CONCLUSION: A 36-year-old woman with resistant tricuspid valve endocarditis was successfully treated with linezolid in combination with daptomycin.
Asunto(s)
Antibacterianos/uso terapéutico , Daptomicina/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Linezolid/uso terapéutico , Infecciones Estafilocócicas/tratamiento farmacológico , Adulto , Antibacterianos/farmacología , Daptomicina/farmacología , Farmacorresistencia Bacteriana Múltiple , Sustitución de Medicamentos , Sinergismo Farmacológico , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/microbiología , Femenino , Gentamicinas/farmacología , Gentamicinas/uso terapéutico , Humanos , Linezolid/farmacología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/microbiología , Resultado del Tratamiento , Válvula Tricúspide/microbiología , Vancomicina/farmacología , Vancomicina/uso terapéuticoRESUMEN
We describe a rare case of tricuspid valve endocarditis caused by Pasteurella multocida in an elderly woman with no previous history of valvular heart disease. Risk factors included contact with animals and old age. The patient was treated successfully with five days of intravenous ampicillin followed by four weeks of oral ciprofloxacin.
Asunto(s)
Enfermedades de las Válvulas Cardíacas , Infecciones por Pasteurella , Pasteurella multocida , Válvula Tricúspide/microbiología , Anciano de 80 o más Años , Ampicilina/uso terapéutico , Antibacterianos/uso terapéutico , Sangre/microbiología , Ciprofloxacina/uso terapéutico , Medios de Cultivo , Ecocardiografía , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/microbiología , Femenino , Enfermedades de las Válvulas Cardíacas/diagnóstico , Enfermedades de las Válvulas Cardíacas/tratamiento farmacológico , Enfermedades de las Válvulas Cardíacas/microbiología , Humanos , Infecciones por Pasteurella/diagnóstico , Infecciones por Pasteurella/tratamiento farmacológico , Infecciones por Pasteurella/microbiología , Pasteurella multocida/efectos de los fármacos , Pasteurella multocida/aislamiento & purificación , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Two cases of tricuspid valve endocarditis due to staphylococcus epidermidis have been examined in patients with permanent transvenous pacemaker. While transthoracic echocardiography was unable to detect any tricuspidal abnormalities, large vegetations located on the tricuspidal leaflets and the electrocatheter were detected by transesophageal echocardiography. Both cases required surgical removal of the electrostimulation system and valve toilet.
Asunto(s)
Ecocardiografía Transesofágica , Endocarditis Bacteriana/diagnóstico por imagen , Endocarditis Bacteriana/etiología , Marcapaso Artificial/efectos adversos , Infecciones Estafilocócicas/diagnóstico por imagen , Infecciones Estafilocócicas/etiología , Staphylococcus epidermidis , Válvula Tricúspide/diagnóstico por imagen , Anciano , Endocarditis Bacteriana/microbiología , Femenino , Enfermedades de las Válvulas Cardíacas/diagnóstico por imagen , Enfermedades de las Válvulas Cardíacas/etiología , Humanos , Masculino , Infecciones Estafilocócicas/microbiología , Válvula Tricúspide/microbiologíaRESUMEN
Candida endocarditis of native valves is difficult to diagnose and treat. The majority of cases require valve replacement and long term amphotericin treatment. We describe a case of Candida endocarditis which was successfully managed with fluconazole without valve replacement. The patient has now been reviewed for 4.5 years from the time of diagnosis and 39 months since treatment was discontinued.