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Year : 2019  |  Volume : 9  |  Issue : 4  |  Page : 164-168

Gemella endocarditis: A case report and a review of the literature

1 Division of Infectious Disease, Ascension Saint John Hospital and Medical Center, Detroit, USA
2 Michigan Medicine, University of Michigan, Ann Arbor, USA
3 Division of Cardiology, Ascension Saint John Hospital and Medical Center, Detroit, USA

Correspondence Address:
Dr. Dima Youssef
Ascension Health, Saint John Hospital and Medical Center, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, Michigan 48236
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/AJM.AJM_3_19

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Infective endocarditis (IE) remains a prevalent disease with a high rate of morbidity and mortality. Recent changes have been noted in the profile of causative microorganisms. In this report, we describe a case of Gemella-related endocarditis and review the related literature. Our patient was an 81-year-old man who presented with dyspnea and fatigue. His initial examination revealed a new systolic murmur. Echocardiogram revealed moderate mitral regurgitation with 1-cm mass on the anterior mitral leaflet, and blood cultures grew Gemella haemolysans. Penicillin and gentamicin were initiated, and workup for possible source was positive for a colonic polyp with high-grade dysplasia. The patient subsequently developed cardiogenic shock and severe pulmonary edema. Comfort care measures were initiated, and he passed away thereafter. We reviewed PubMed for cases of Gemella-related endocarditis. We found 65 documented cases and added our patient’s case to the analysis. Seventy-two percent of the cases occurred in men. The mean age was 51 years and 42% of the patients were older than 60 years. Fever was the most common presenting symptom and most of the cases presented subacutely. The mitral valve was the most affected site and 50% of the patients required surgical intervention. G. morbillorum was the most common subtype and a total of four cases were found to be associated with colorectal neoplasm. As a conclusion, Gemella species rarely cause IE. The absence of a clear source of bacteremia warrants further evaluation for a gastrointestinal source. The infection can be destructive and must be promptly treated to avoid complications.

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