Table 1 Clinical characteristics of patients with endocarditis caused by Enterococcus hirae
From: Native-valve Enterococcus hirae endocarditis: a case report and review of the literature
Patient | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
Age, y | 72 | 78 | 56 | 70 | 64 |
Sex | M | F | M | M | F |
Valve involvement | Aortic insufficiency. | Vegetation on aortic prosthetic valve present during relapse; normal TTE/TEE upon initial presentation. | Aortic and mitral valve reflux. | Severe aortic regurgitation with prolapse, fusion, small echodensity, and perforation of aortic cusps. | Bicuspid aortic valve with stenosis, root abscess, calcifications; no evidence of vegetations or abscess on TTE. |
Medical history | Coronary artery disease, percutaneous transluminal coronary angioplasty. | Diabetes mellitus, hypertension, prior aortic valve replacement with bioprosthetic. | Hypertension, diabetes mellitus, cardiac arrhythmia with prior surgical ablation, surgical removal of gastric leiomyoma. | Unknown. | Hodgkin’s lymphoma, asthma, achalasia, recurrent right lower extremity DVT, fibromyalgia, cholecystectomy. |
Identification | sodAint gene sequencing. | 16S rNA, sodAint gene sequencing. | Unknown. | MALDI-TOF. | MALDI-TOF. |
Treatment | Aortic valve replacement. Ampicillin and gentamicin (4 weeks), with rifampin added (15 days); total 4 weeks. | Amoxicillin and gentamicin (2 weeks), followed by amoxicillin and rifampin (4 weeks); total 6 weeks. | Aortic valve replacement. Ampicillin and gentamicin (4 weeks), followed by amoxicillin and rifampin (2 weeks); total 6 weeks. | Aortic valve replacement. Ampicillin and ceftriaxone, followed by IV penicillin G and ceftriaxone for 6 weeks, with indefinite chronic suppressive therapy of oral penicillin. | Aortic valve replacement. Ampicillin and ceftriaxone (6 weeks). |
Relapse | Yes, 3 months after antibiotic discontinuation. Treated with aortic valve replacement and vancomycin/gentamicin (6 weeks) followed by amoxicillin (2 weeks) for a total of 8 weeks of antibiotic therapy. Resolved. | Yes, 4 months after antibiotic discontinuation. Treated with the same regimen as before. Surgery contraindicated by poor patient condition. Resolved. | No. | No. | No. |
Notes | Subacute presentation. | Subacute presentation. No evidence of endocarditis on initial TTE/TEE. Multiple colonic polyps removed. Post-relapse, colonic polyp with non-neoplastic adenoma removed. The only case of the five not to require aortic valve replacement, although the infected valve was already a prosthetic valve. | Presented acutely as neurological deficit with slurred speech and left hemiparesis. | Subacute presentation with 3 months of bilateral lower extremity edema, exertional dyspnea, and fatigue; 1 year of fevers and mild weight loss. Lived in Vietnam for 2 years, with travel throughout Southeast Asia. | Presented acutely as hypotension and atrial fibrillation with rapid ventricular response. |
Year of publication, reference | 2002 [8] | 2011 [9] | 2013 [10] | 2019 [11] | 2019 |