Chest
Volume 75, Issue 1, January 1979, Pages 85-86
Journal home page for Chest

Selected Reports
Endocarditis due to Strain of Cardiobacterium hominis Resistant to Erythromycin and Vancomycin

https://doi.org/10.1378/chest.75.1.85Get rights and content

Endocarditis caused by Cardiobacterium hominis was observed in a penicillin-allergic patient with a prosthetic cardiac valve who had received prophylactic therapy with erythromycin for dental extractions. The organism was resistant to erythromycin and vancomycin, with minimal inhibitory concentrations of 12.5µg/ml and 25/µg/ml, respectively, but was sensitive to penicillin G, tetracycline, cephalexin, and cefaclor. This case suggests that currently recommended antibiotic prophylactic therapy for endocarditis, especially in penicillin-allergic patients, may be inadequate for unusual pathogens such as C hominis.

Section snippets

Case Report

A 47-year-old woman who had been in good health noted the gradual onset of fatigue, night sweats, and loss of weight six months before admission. Three years previously, a Starr-Edwards mitral valve prosthesis and a transvenous demand pacemaker were inserted because of atrial flutter with high-degree atrioventricular block and rheumatic mitral stenosis. Two months before the onset of symptoms, extractions of carious teeth were performed on three occasions. Because of a history of an allergy to

Discussion

The minimal inhibitory concentrations (MICs) of erythromycin, vancomycin, penicillin G, tetracycline, cephalexin, and cefaclor were determined using a microdilution broth technique with trypticase soy broth (BBL) and a final inoculum of 105 to 106 colonyforming units of the C hominis per milliliter. After 48 hours of incubation at 37°C in 5 percent carbon dioxide, the values for MIC were read as the lowest concentration of drug that inhibited visible growth. The minimal bactericidal

ACKNOWLEDGMENT

We thank Ms. Jean Barnishan and Ms. Lisa Stone for expert technical assistance.

References (7)

  • IJ Slotnick et al.

    Further characterization of an unclassified group of bacteria causing endocarditis in man: Cardiobacterium hominis gen. et sp. n. Antonie van Leeuwenhoek

    J Microbiol Serol

    (1964)
  • M Weiner et al.

    Cardiobacterium hominis endocarditis: Characterization of the unusual organism and review of the literature

    Am J Clin Pathol

    (1975)
  • DD Savage, et al.

    Cardiobacterium hominis endocarditis: Description in two patients and characterization of the organism

    J Clin Microbiol

    (1977)
There are more references available in the full text version of this article.

Cited by (0)

View full text