American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2020, 8(11), 405-408
DOI: 10.12691/ajmcr-8-11-7
Open AccessCase Report

Paravalvular Abscess as a Complication of Streptococcus Salivarius Infective Endocarditis of a Bioprosthetic Aortic Valve

Gil Hevroni1, Andrii Maryniak1, Diego Cepeda-Mora1, Moro O. Salifu1 and Samy I. McFarlane1,

1Department of Internal Medicine, SUNY-Downstate Health Science University, Brooklyn, New York, United States-11203

Pub. Date: July 23, 2020

Cite this paper:
Gil Hevroni, Andrii Maryniak, Diego Cepeda-Mora, Moro O. Salifu and Samy I. McFarlane. Paravalvular Abscess as a Complication of Streptococcus Salivarius Infective Endocarditis of a Bioprosthetic Aortic Valve. American Journal of Medical Case Reports. 2020; 8(11):405-408. doi: 10.12691/ajmcr-8-11-7

Abstract

Rates of implantation of prosthetic valves and cardiac devices have increased significantly in the last thirty years, accounting, at least in-part, for the growing incidence of infective endocarditis cases. Prosthetic valve endocarditis (PVE) is an endovascular, microbial infection occurring on parts of a valve prosthesis or on reconstructed native heart valves. We present a case of a 63-year-old man with multiple comorbidities including extensive cardiovascular disease, who recently underwent bioprosthetic aortic valve replacement. Patient presented to the emergency department with exertional chest pain, dyspnea, fever, melena and lethargy. Blood cultures grew Streptococcus salivarius and transesophageal echocardiography confirmed PVE with an aortic paravalvular abscess. The patient was treated with appropriate antimicrobial therapy based on culture sensitivity and subsequently referred to cardiothoracic surgery for urgent evaluation. This case highlights several important points which include but are not limited to: investigation into the pathogen Streptococcus salivarius and its relationship to other known pathogens, understanding of the complications associated with PVE, and the importance of early identification of PVE and initiation of medical and surgical therapy with respect to prognosis.

Keywords:
prosthetic valve endocarditis paravalvular abscess bioprosthetic aortic valve streptococcus salivarius

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