Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Nov 26;57(12):1298.
doi: 10.3390/medicina57121298.

A Challenge of COVID-19: Associated Infective Endocarditis with Streptococcus gordonii in a Young Immunocompetent Patient

Manuela Arbune  1 , Alina-Viorica Iancu  2 , Gabriela Lupasteanu  3 , Mihaela-Camelia Vasile  1 , Victorita Stefanescu  2
Affiliations
Case Reports

A Challenge of COVID-19: Associated Infective Endocarditis with Streptococcus gordonii in a Young Immunocompetent Patient

Manuela Arbune et al. Medicina (Kaunas). .

Abstract

The COVID-19 pandemic is a new challenge for the diagnosis and treatment of infective endocarditis (IE). Fever and other unspecific symptoms of coronaviral infection could be misleading or masking its manifestations. We present the case of a young patient admitted for persistent fever, profuse sweating, headache, articular pain, myalgias, and weight loss. She reported regression taste and smell disorders compared to a month earlier when diagnosed with moderate COVID-19 pneumonia. While the RT-PCR SARS-COV-2 test was positive, she was admitted to a COVID-19 ward. Investigations of febrile syndrome revealed two positive blood cultures with Streptococcus gordonii and the presence of vegetations on the aortic valve, supporting a certain diagnosis of IE. After six weeks of antibiotic treatment, the patient had clinical and biologic favorable outcomes. Streptococcus gordonii is a common commensal related to the dental biofilm, although there were no caries in our patient. The influence of COVID-19 infection on the human microbiome by modifying the virulence of some commensal germs may be a risk factor for IE pathogenesis on native valves and requires the vigilance of clinicians for suspicion of this disease.

Keywords: COVID-19; Streptococcus gordonii; infectious endocarditis; oral microbiome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Transthoracic Echocardiogram: Vegetation on aortic cusp related to infective endocarditis concomitant with COVID-19.
See this image and copyright information in PMC

References

    1. Lang J.P., Wang X., Moura F.A., Siddiqi H.K., Morrow D.A., Bohula E.A. A current review of COVID-19 for the cardiovascular specialist. Am. Heart J. 2020;226:29–44. doi: 10.1016/j.ahj.2020.04.025. - DOI - PMC - PubMed
    1. Kariyanna P.T., Jayarangaiah A., Dulal J., Jayarangaiah A., Das S., Punnakudiyil G.J., Tadayoni A., Freilich M., McFarlane I.M. Infective Endocarditis and COVID 19: A Systematic Review. Am. J. Med. Case Rep. 2021;9:380–385. doi: 10.12691/ajmcr-9-7-11. - DOI
    1. Escolà-Vergé L., Cuervo G., de Alarcón A., Sousa D., Barca L.V., Fernández-Hidalgo N., Gutiérrez-Carretero E., Luque-Márquez R., Baz B.A., López-Cortés L.E., et al. Impact of the COVID-19 pandemic on the diagnosis, management and prognosis of infective endocarditis. Clin. Microbiol. Infect. 2021;27:660–664. doi: 10.1016/j.cmi.2020.11.022. - DOI - PMC - PubMed
    1. Mihos C.G., Nappi F. A narrative review of echocardiography in infective endocarditis of the right heart. Ann. Transl. Med. 2020;8:1622. doi: 10.21037/atm-20-5198. - DOI - PMC - PubMed
    1. Habib G., Lancellotti P., Antunes M.J., Bongiorni M.G., Casalta J.-P., Del Zotti F., Dulgheru R., El Khoury G., Erba P.A., Iung B., et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Associ-ation for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM) Eur. Heart J. 2015;36:3075–3128. doi: 10.1093/eurheartj/ehv319. - DOI - PubMed

Publication types