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Open Access Case report

Granulicatella bacteraemia in children: two cases and review of the literature

Maia De Luca1*, Donato Amodio1, Sara Chiurchiù1, Maria Assunta Castelluzzo1, Gabriele Rinelli2, Paola Bernaschi3, Francesca Ippolita Calò Carducci1 and Patrizia D’Argenio1

Author Affiliations

1 Unit of Immunology and Infectious Disease, University Hospital Pediatric Department, Bambino Gesù Children’s Hospital, Piazza Sant’Onofrio 4, Rome, Italy

2 Unit of Cardiology, Bambino Gesù Children’s Hospital, Piazza Sant’Onofrio 4, Rome, Italy

3 Unit of Microbiology, Department of Laboratories, Bambino Gesù Children’s Hospital, Piazza Sant’Onofrio 4, Rome, Italy

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BMC Pediatrics 2013, 13:61  doi:10.1186/1471-2431-13-61

Published: 22 April 2013

Abstract

Background

Granulicatella spp. is a fastidious bacteria responsible for bacteremia and endocarditis which are fatal in about 20% of the cases. These severe infections are uncommon in children under 17 years of age and have proven extremely difficult to treat.

Cases presentation

We report a brief review of the literature and two cases of NVS bacteremia by Granulicatella complicated by infective endocarditis (IE). The first one is that of a 7-year-old Caucasian female with Shone syndrome and IE involving the pulmonary valve homograft, confirmed by echocardiography. The second case is that of a 5-year-old Caucasian male. In this patient echocardiogram was negative for signs of IE; however, a “possible” IE was suspected on the basis of a cardiac catheterization 3 weeks before the onset of fever. Since in both our patients clinical failure of first line antibiotic treatment was observed, we used a combination of meropenem with another anti-streptococcal drug with excellent results.

Conclusion

In Granulicatella bacteremia in the pediatric population, combination antimicrobial therapy including meropenem should be considered as a second line treatment in non-responding patients.

Keywords:
Granulicatella; Endocarditis; Bacteremia; NVS; Treatment; Meropenem; Paediatrics