BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Online) |
Texto Completo: | http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/907 |
Resumo: | Introduction: Infectious endocarditis is an inflammatory lesion of the endocardium and heart valves. It has a predilection for males and over 65 years of age. The use of intravenous drugs, surgical dental procedures and rheumatic heart disease are factors that favor its development. The clinical picture is diverse and non-specific, which makes its diagnosis difficult. Associating the clinic with imaging and microbiological data, and based on the Modified Duke Criteria, it is possible to make a definitive diagnosis. Among the rarely reported endocarditis-causing pathogens is the bacterium Ochrobactrum anthropi. This species is resistant to several antibiotics used in the clinic, such as beta-lactams. It is generally sensitive to gentamicin, polymyxins, sulfamethoxazole-trimethoprim and fluoroquinolones. Objective: Report a case of bacterial endocarditis caused by Ochrobactrum anthropi. Case report: Patient 30 years old, male, without previous comorbidities, physician. In November 2019 he started having a headache and fever. With the hypothesis of acute bacterial sinusitis, he used amoxicillin with clavulanate, with total improvement of symptoms. However, the symptoms returned, causing him to use levofloxacin, with partial improvement of the condition. He went to Hospital Santa Rita, where a systolic heart murmur was detected in the aortic area, and a transthoracic echocardiogram was requested, which showed interventricular communication and a mobile pedunculated image suggestive of vegetation. He was admitted to receive broad-spectrum antibiotic therapy, with ceftriaxone and vancomycin, for a total of six weeks. To correct the lesions, he performed ventriculoseptoplasty, atrioseptorrhaphy, aortic valve repair and removal of vegetating lesions on November 9, 2020, at Hospital Unimed de Vitória. The surgically removed cardiac tissue fragment was sent to the Tommasi laboratory for examinations, in which the presence of gram-negative rods, identified as the Ochrobactrum anthropi bacteria, was observed. He started treatment with meropenem and was discharged on November 19, 2020. He completed antibiotic therapy at home until the end of six weeks. Conclusion: Ochrobactrum anthropi is a rare etiologic agent and this information on bacterial endocarditis can favor the elucidation of infections that are difficult to diagnose, expanding the possibility of a more adequate therapeutic approach for the patient. |
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BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORTEndocardite bacteriana causada por Ochrobactrum anthropi: relato de caso / Bacterial endocarditis caused by Ochrobactrum anthropi: case reportEndocarditisAortic valveOchrobactrum anthropiIntroduction: Infectious endocarditis is an inflammatory lesion of the endocardium and heart valves. It has a predilection for males and over 65 years of age. The use of intravenous drugs, surgical dental procedures and rheumatic heart disease are factors that favor its development. The clinical picture is diverse and non-specific, which makes its diagnosis difficult. Associating the clinic with imaging and microbiological data, and based on the Modified Duke Criteria, it is possible to make a definitive diagnosis. Among the rarely reported endocarditis-causing pathogens is the bacterium Ochrobactrum anthropi. This species is resistant to several antibiotics used in the clinic, such as beta-lactams. It is generally sensitive to gentamicin, polymyxins, sulfamethoxazole-trimethoprim and fluoroquinolones. Objective: Report a case of bacterial endocarditis caused by Ochrobactrum anthropi. Case report: Patient 30 years old, male, without previous comorbidities, physician. In November 2019 he started having a headache and fever. With the hypothesis of acute bacterial sinusitis, he used amoxicillin with clavulanate, with total improvement of symptoms. However, the symptoms returned, causing him to use levofloxacin, with partial improvement of the condition. He went to Hospital Santa Rita, where a systolic heart murmur was detected in the aortic area, and a transthoracic echocardiogram was requested, which showed interventricular communication and a mobile pedunculated image suggestive of vegetation. He was admitted to receive broad-spectrum antibiotic therapy, with ceftriaxone and vancomycin, for a total of six weeks. To correct the lesions, he performed ventriculoseptoplasty, atrioseptorrhaphy, aortic valve repair and removal of vegetating lesions on November 9, 2020, at Hospital Unimed de Vitória. The surgically removed cardiac tissue fragment was sent to the Tommasi laboratory for examinations, in which the presence of gram-negative rods, identified as the Ochrobactrum anthropi bacteria, was observed. He started treatment with meropenem and was discharged on November 19, 2020. He completed antibiotic therapy at home until the end of six weeks. Conclusion: Ochrobactrum anthropi is a rare etiologic agent and this information on bacterial endocarditis can favor the elucidation of infections that are difficult to diagnose, expanding the possibility of a more adequate therapeutic approach for the patient.Introdução: A endocardite infecciosa é uma lesão inflamatória do endocárdio e das valvas cardíacas. Possui predileção pelo sexo masculino e idade maior que 65 anos. O uso de drogas intravenosas, procedimentos odontológicos cirúrgicos e doença cardíaca reumática são fatores que favorecem seu desenvolvimento. O quadro clínico é diversificado e não específico, o que dificulta seu diagnóstico. Associando a clínica com examede imagem e dados microbiológicos, e baseando-se nos Critérios Duke Modificados, é possível fazer o diagnóstico definitivo. Entre os patógenos causadores de endocardite raramente relatados, está a bactéria Ochrobactrum anthropi. Essa espécie apresenta resistência a vários antibióticos utilizados na clínica, como os betalactâmicos. De forma geral, é sensível à gentamicina, polimixinas, sulfametoxazol-trimetoprim e fluoroquinolonas. Objetivo: Relatar um caso de endocardite bacteriana causada por Ochrobactrum anthropi. Relato do caso: Paciente, 30 anos, sexo masculino, sem comorbidades prévias, médico. Em novembro de 2019, iniciou quadro de cefaleia e febre. Ante a hipótese de sinusite bacteriana aguda, fez uso de amoxicilina com clavulanato, com melhora total do quadro. Os sintomas retornaram e iniciou uso de levofloxacino, com melhora parcial. Buscou o Hospital Santa Rita, onde detectou-se sopro cardíaco sistólico em foco aórtico, sendo solicitado um ecocardiograma transtorácico que evidenciou comunicação interventricular e imagem pedunculada móvel sugestiva de vegetação. Foi internado para receber antibioticoterapia de amplo espectro, com ceftriaxone e vancomicina, pelo total de seis semanas. Para correção das lesões, realizou ventriculosseptoplastia, atriosseptorrafia, plastia de valva aórtica e retirada das lesões vegetantes em 09 de novembro de 2020, no Hospital Unimed de Vitória. O fragmento do tecido cardíaco retirado em cirurgia foi enviado ao laboratório Tommasi para realização de exames, nos quais observou-se a presença de bastonetes gram-negativos, identificados como a bactéria Ochrobactrum anthropi. Iniciou tratamento com meropenem e recebeu alta em 19 de novembro de 2020. Concluiu a antibioticoterapia em domicílio até finalizar seis semanas. Conclusão: O Ochrobactrum anthropi é um agente etiológico raro, e essas informações sobre endocardite bacteriana podem favorecer a elucidação de infecções de difícil diagnóstico, ampliando a possibilidade de abordagem terapêutica mais adequada do paciente.Palavras-chave: Endocardite, Valva aórtica, Ochrobactrum anthropi ABSTRACT: Introduction: Infectious endocarditis is an inflammatory lesion of the endocardium and heart valves. It has a predilection for males and over 65 years of age. The use of intravenous drugs, surgical dental procedures and rheumatic heart disease are factors that favor its development. The clinical picture is diverse and non-specific, which makes its diagnosis difficult. Associating the clinic with imaging and microbiological data, and based on the Modified Duke Criteria, it is possible to make a definitive diagnosis. Among the rarely reported endocarditis-causing pathogens is the bacterium Ochrobactrum anthropi. This species is resistant to several antibiotics used in the clinic, such as beta-lactams. It is generally sensitive to gentamicin, polymyxins, sulfamethoxazole-trimethoprim and fluoroquinolones. Objective: To report a case of bacterial endocarditis caused by Ochrobactrum anthropi. Case report: Thirty year-old, male patient, without previous comorbidities, a physician. In November 2019 he started having a headache and fever. With the hypothesis of acute bacterial sinusitis, he used amoxicillin with clavulanate, with total improvement of symptoms. However, the symptoms returned, causing him to use levofloxacin, with partial improvement of the condition. He went to Hospital Santa Rita, where a systolic heart murmur was detected in the aortic area, and a transthoracic echocardiogram was requested, which showed interventricular communication and a mobile pedunculated image suggestive of vegetation. He was admitted to receive broad-spectrum antibiotic therapy, with ceftriaxone and vancomycin, for a total of six weeks. To correct the lesions, he performed ventriculoseptoplasty, direct suture of the atrial septum, aortic valve repair and removal of vegetating lesions on November 9, 2020, at Hospital Unimed de Vitória. The surgically removed cardiac tissue fragment was sent to the Tommasi laboratory for examinations, in which the presence of gram-negative rods, identified as the Ochrobactrum anthropi bacteria, was observed. He started treatment with meropenem and was discharged on November 19, 2020. He completed antibiotic therapy at home until the end of six weeks. Conclusion: Ochrobactrum anthropi is a rare etiologic agent and this information on bacterial endocarditis can favor the elucidation of infections that are difficult to diagnose, expanding the possibility of a more adequate therapeutic approach for the patient. Keywords: Endocarditis, Aortic valve, Ochrobactrum anthropiFaculdade de Ciências Médicas da Santa Casa de São Paulo2023-03-14info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/90710.26432/1809-3019.2022.67.028Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo; V. 67 (2022): Jan/Dez; 1 of 81809-30190101-6067reponame:Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Online)instname:Faculdade de Ciências Médicas da Santa Casa de São Pauloinstacron:FCMSCSPporhttp://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/907/1192Copyright (c) 2023 Beatriz Dias da Costa, Diandra Zapata Galvêas Miranda, Luana Manhães Ferreira, Maria das Graças Silva Mattede, José Augusto Murad, Luciana Galvêas de Miranda, Lucas Crespo de Barroshttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCosta, Beatriz Dias daMiranda, Diandra Zapata GalvêasFerreira, Luana ManhãesMattede, Maria das Graças SilvaMurad, José AugustoMiranda, Luciana Galvêas deBarros, Lucas Crespo de2023-03-15T18:22:52Zoai:ojs2.arquivosmedicos.fcmsantacasasp.edu.br:article/907Revistahttp://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSPONGhttp://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/oaiarquivosmedicos@fcmsantacasasp.edu.br||1809-30190101-6067opendoar:2023-03-15T18:22:52Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Online) - Faculdade de Ciências Médicas da Santa Casa de São Paulofalse |
dc.title.none.fl_str_mv |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT Endocardite bacteriana causada por Ochrobactrum anthropi: relato de caso / Bacterial endocarditis caused by Ochrobactrum anthropi: case report |
title |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT |
spellingShingle |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT Costa, Beatriz Dias da Endocarditis Aortic valve Ochrobactrum anthropi |
title_short |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT |
title_full |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT |
title_fullStr |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT |
title_full_unstemmed |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT |
title_sort |
BACTERIAL ENDOCARDITIS CAUSED BY Ochrobactrum anthropi: CASE REPORT |
author |
Costa, Beatriz Dias da |
author_facet |
Costa, Beatriz Dias da Miranda, Diandra Zapata Galvêas Ferreira, Luana Manhães Mattede, Maria das Graças Silva Murad, José Augusto Miranda, Luciana Galvêas de Barros, Lucas Crespo de |
author_role |
author |
author2 |
Miranda, Diandra Zapata Galvêas Ferreira, Luana Manhães Mattede, Maria das Graças Silva Murad, José Augusto Miranda, Luciana Galvêas de Barros, Lucas Crespo de |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Costa, Beatriz Dias da Miranda, Diandra Zapata Galvêas Ferreira, Luana Manhães Mattede, Maria das Graças Silva Murad, José Augusto Miranda, Luciana Galvêas de Barros, Lucas Crespo de |
dc.subject.por.fl_str_mv |
Endocarditis Aortic valve Ochrobactrum anthropi |
topic |
Endocarditis Aortic valve Ochrobactrum anthropi |
description |
Introduction: Infectious endocarditis is an inflammatory lesion of the endocardium and heart valves. It has a predilection for males and over 65 years of age. The use of intravenous drugs, surgical dental procedures and rheumatic heart disease are factors that favor its development. The clinical picture is diverse and non-specific, which makes its diagnosis difficult. Associating the clinic with imaging and microbiological data, and based on the Modified Duke Criteria, it is possible to make a definitive diagnosis. Among the rarely reported endocarditis-causing pathogens is the bacterium Ochrobactrum anthropi. This species is resistant to several antibiotics used in the clinic, such as beta-lactams. It is generally sensitive to gentamicin, polymyxins, sulfamethoxazole-trimethoprim and fluoroquinolones. Objective: Report a case of bacterial endocarditis caused by Ochrobactrum anthropi. Case report: Patient 30 years old, male, without previous comorbidities, physician. In November 2019 he started having a headache and fever. With the hypothesis of acute bacterial sinusitis, he used amoxicillin with clavulanate, with total improvement of symptoms. However, the symptoms returned, causing him to use levofloxacin, with partial improvement of the condition. He went to Hospital Santa Rita, where a systolic heart murmur was detected in the aortic area, and a transthoracic echocardiogram was requested, which showed interventricular communication and a mobile pedunculated image suggestive of vegetation. He was admitted to receive broad-spectrum antibiotic therapy, with ceftriaxone and vancomycin, for a total of six weeks. To correct the lesions, he performed ventriculoseptoplasty, atrioseptorrhaphy, aortic valve repair and removal of vegetating lesions on November 9, 2020, at Hospital Unimed de Vitória. The surgically removed cardiac tissue fragment was sent to the Tommasi laboratory for examinations, in which the presence of gram-negative rods, identified as the Ochrobactrum anthropi bacteria, was observed. He started treatment with meropenem and was discharged on November 19, 2020. He completed antibiotic therapy at home until the end of six weeks. Conclusion: Ochrobactrum anthropi is a rare etiologic agent and this information on bacterial endocarditis can favor the elucidation of infections that are difficult to diagnose, expanding the possibility of a more adequate therapeutic approach for the patient. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-03-14 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/907 10.26432/1809-3019.2022.67.028 |
url |
http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/907 |
identifier_str_mv |
10.26432/1809-3019.2022.67.028 |
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por |
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por |
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http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/907/1192 |
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https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
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https://creativecommons.org/licenses/by/4.0 |
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openAccess |
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application/pdf |
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Faculdade de Ciências Médicas da Santa Casa de São Paulo |
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Faculdade de Ciências Médicas da Santa Casa de São Paulo |
dc.source.none.fl_str_mv |
Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo; V. 67 (2022): Jan/Dez; 1 of 8 1809-3019 0101-6067 reponame:Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Online) instname:Faculdade de Ciências Médicas da Santa Casa de São Paulo instacron:FCMSCSP |
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Faculdade de Ciências Médicas da Santa Casa de São Paulo |
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FCMSCSP |
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FCMSCSP |
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Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Online) |
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Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Online) |
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Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Online) - Faculdade de Ciências Médicas da Santa Casa de São Paulo |
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arquivosmedicos@fcmsantacasasp.edu.br|| |
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