Poster Session : PS 0409 ; Infectious Disease ; Prosthetic Valve Endocarditis Caused by Neisseria Elongata: A Case Report = Poster Session : PS 0409 ; Infectious Disease ; Prosthetic Valve Endocarditis Caused by Neisseria Elongata: A Case Report

다국어 초록 (Multilingual Abstract)

Background: Neisseria elongate is a gram negative rod that is different from the other cocci shaped members of the genus Neisseria. It is a commensal bacterium of nose and pharynx, which has recently been recognized as a rare cause of infective endocarditis. Case report: In this report, we describe a case of N. elongata endocarditis associated with cerebellar and splenic infarction in a patient with a prosthetic heart valve. A 71-year-old man was admitted with high fever for a week. He had undergone a prosthetic valve replacement for aortic stenosis and Streptococcus mitis endocarditis in mitral valve 12 years ago. An echocardiogram demonstrated a vegetation-like echogenic structure on the lateral leafi et of the patient`s prosthetic valve. Two blood cultures grew gram-negative rod that were confi rmed to be N. elongate. Through a molecular approach based on 16S ribosomal, the organism responsible for the infective endocarditis conclusively isolated N. elongate. On the 9th admission day, he presented with drowsy mentality. Cranial magnetic resonance imaging revealed abnormalities consistent with acute bilateral cerebellar infarction, and abdomen computed tomography showed irregular shaped low attenuating lesion at the upper area of spleen as splenic infarction. The isolate was susceptible to ampicillin/sulbactam, ceftriaxone, ceftazidime, ciprofi oxacin, and gentamicin. The patient recovered after 71 days of antibiotic therapy with ceftriaxone (2 g per a day). Conclusion: Our case demonstrated that N. elongate is not only a commensal organism of the human but also an important pathogen that cause the complicated infective endocarditis. Furthermore, in a patient with a prosthetic valve, urgent and appropriate antibiotic therapy is crucial for the successful treatment of the case with the complicated N. elongata endocarditis.