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Case Reports
. 2013 Oct 9:2013:bcr2013200534.
doi: 10.1136/bcr-2013-200534.

The first report of survival post Rothia aeria endocarditis

Arun Thiyagarajan  1 , Anjella Balendra, David Hillier, James Hatcher
Affiliations
Case Reports

The first report of survival post Rothia aeria endocarditis

Arun Thiyagarajan et al. BMJ Case Rep. .

Abstract

A 61-year-old patient presented with drowsiness, decreased appetite and weight loss. On examination he had several splinter haemorrhages and a tender mass over the right temporal region. Respiratory and abdominal examinations were unremarkable and heart sounds were normal with no clinically audible murmurs. He spiked regular temperatures and consequently had several blood cultures taken. Transthoracic and transoeseophageal echocardiogram showed a 3 cm mitral valve vegetation. MRI confirmed suspicions of septic emboli in the brain. Blood cultures grew Rothia aeria and he was started on benzylpenicillin, rifampicin and gentamicin. After a period of observation he deteriorated clinically and biochemically, surgical intervention therefore ensued with an urgent metallic mitral valve replacement. Nineteen days postsurgery the patient was successfully discharged on outpatient antibiotic therapy and warfarin. In view of complications such as embolisation and cerebral infarction, R aeria endocarditis should be managed aggressively and with a high index of clinical suspicion.

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Figures

Figure 1
Figure 1
Gram stain direct from aerobic blood culture showing filamentous Gram-positive bacilli (×100 magnification).
See this image and copyright information in PMC

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