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Case Reports
. 2019 Jun 10;19(1):511.
doi: 10.1186/s12879-019-4149-2.

Actinomyces neuii: a case report of a rare cause of acute infective endocarditis and literature review

Wei-Teng Yang  1 , Matthew Grant  2
Affiliations
Case Reports

Actinomyces neuii: a case report of a rare cause of acute infective endocarditis and literature review

Wei-Teng Yang et al. BMC Infect Dis. .

Abstract

Background: Infective endocarditis caused by Actinomyces spp. is extremely rare. However, cases by new species of Actinomyces have been increasingly reported due to advances in laboratory techniques, and many of these species do not cause classic presentations of actinomycosis. Actinomyces neuii is reported to have a tendency to cause endovascular infection. The course of infective endocarditis caused by Actinomyces spp. is usually indolent.

Case presentation: A 61-year-old man with history of infective endocarditis, end stage renal disease, and monoclonal gammopathy was admitted for an abrupt fever, confusion, dysarthria, and facial droop after hemodialysis. Echocardiogram showed vegetations on both the aortic and mitral valves. Two sets of blood culture grew A. neuii. Brain MRI showed multiple bilateral cerebral infarcts consistent with septic emboli. The patient recovered after valvular surgery and prolonged intravenous and oral antibiotic therapy.

Conclusions: This case illustrates an unusually acute presentation of A. neuii infective endocarditis. As with other Gram-positive bacilli, Actinomyces spp. isolates are often regarded as a result of contamination. One should keep it in mind as a cause of infective endocarditis in vulnerable patient populations.

Keywords: Actinomyces; Actinomyces neuii; Infective endocarditis.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Transthoracic echocardiogram showed two vegetations on the aortic and mitral valves. Legend: Vegetations on the aortic valve (panel a) and the mitral valve (panel b) were pointed by arrows
Fig. 2
Fig. 2
Gram stain morphology of A. neuii bacteria. Legend: A. neuii bacteria were shown as small, Gram- positive rods. They are non-filamentous and do not produce sulfur granules seen commonly with other Actinomyces species
See this image and copyright information in PMC

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