A Challenge of COVID-19: Associated Infective Endocarditis with Streptococcus gordonii in a Young Immunocompetent Patient.
Manuela ArbuneAlina Viorica IancuGabriela LupasteanuMihaela-Camelia VasileVictorita StefanescuPublished in: Medicina (Kaunas, Lithuania) (2021)
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.
Keyphrases
- sars cov
- aortic valve
- case report
- coronavirus disease
- biofilm formation
- candida albicans
- weight loss
- pseudomonas aeruginosa
- staphylococcus aureus
- transcatheter aortic valve replacement
- respiratory syndrome coronavirus
- endothelial cells
- rheumatoid arthritis
- chronic pain
- aortic valve replacement
- palliative care
- aortic stenosis
- oral health
- metabolic syndrome
- type diabetes
- spinal cord injury
- skeletal muscle
- physical activity
- spinal cord
- body mass index
- depressive symptoms
- middle aged
- respiratory failure
- roux en y gastric bypass
- postoperative pain
- replacement therapy
- drug induced