Case report: Infective endocarditis caused by Brevundimonas vesicularis
1 Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan
2 Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Taiwan
3 Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
BMC Infectious Diseases 2006, 6:179 doi:10.1186/1471-2334-6-179Published: 29 December 2006
There are few reports in the literature of invasive infection caused by Brevundimonas vesicularis in patients without immunosuppression or other predisposing factors. The choice of antimicrobial therapy for bacteremia caused by the pathogen requires more case experience to be determined.
The case of a 40-year-old previously healthy man with subacute endocarditis proposed to be contributed from an occult dental abscess is described. The infection was found to be caused by B. vesicularis on blood culture results. The patient recovered without sequelae after treatment with ceftriaxone followed by subsequent ciprofloxacin therapy owing to an allergic reaction to ceftriaxone and treatment failure with ampicillin/sulbactam.
To our knowledge, this is the first report of B. vesicularis as a cause of infective endocarditis. According to an overview of the literature and our experience, we suggest that third-generation cephalosporins, piperacillin/tazobactam, and ciprofloxacin are effective in treating invasive B. vesicularis infections, while the efficacy of ampicillin-sulbactam needs further evaluation.