1
|
Kitagawa I, Ishikawa N, Ono R. Infective endocarditis caused by Lactococcus garvieae: A case report and review of the literature. IDCases 2024; 36:e01941. [PMID: 38699525 PMCID: PMC11063499 DOI: 10.1016/j.idcr.2024.e01941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/22/2024] [Accepted: 04/12/2024] [Indexed: 05/05/2024] Open
Abstract
Lactococcus garvieae is a Gram-positive coccus that can be easily misidentified as Enterococcus spp. or streptococci. Infection with L. garvieae is associated with the consumption of raw fish and unpasteurized dairy products. Although rare, it can cause infective endocarditis (IE). Herein, we report a case in which aortic valve replacement (AVR) was required for IE caused by L. garvieae. A 79-year-old Japanese man with a history of hypertension, myocardial infarction, gastroesophageal reflux disease (GERD), and abdominal aortic aneurysm presented with loss of appetite, myalgia, and difficulty in moving. Physical examination revealed a diastolic murmur, an Osler's node on the right first toe, dental caries, and a palpable spleen, suggesting IE. Transthoracic echocardiography revealed a large, mobile vegetation on the aortic valve, which was associated with severe aortic regurgitation. Blood cultures revealed L. garvieae. The patient received antibiotic therapy, underwent AVR, and recovered without major complications. To date, 30 cases of L. garvieae-associated IE have been reported. We reviewed and summarized all cases of L. garvieae-associated IE including our case.
Collapse
Affiliation(s)
- Izumi Kitagawa
- Department of General Internal Medicine, Shonan Fujisawa Tokushukai Hospital, 1-5-1 Tsujido Kandai, Fujisawa, Kanagawa 251-0041, Japan
| | - Noriyoshi Ishikawa
- Department of Pathology, Shonan Fujisawa Tokushukai Hospital, 1-5-1 Tsujido Kandai, Fujisawa, Kanagawa 251-0041, Japan
| | - Ryohei Ono
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| |
Collapse
|
2
|
Maldonado-barragán A, Alegría-carrasco E, Blanco MDM, Vela AI, Fernández-garayzábal JF, Rodríguez JM, Gibello A. Garvicins AG1 and AG2: Two Novel Class IId Bacteriocins of Lactococcus garvieae Lg-Granada. Int J Mol Sci 2022; 23:4685. [PMID: 35563074 PMCID: PMC9101539 DOI: 10.3390/ijms23094685] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Lactococcus garvieae causes infectious diseases in animals and is considered an emerging zoonotic pathogen involved in human clinical conditions. In silico analysis of plasmid pLG50 of L. garvieae Lg-Granada, an isolate from a patient with endocarditis, revealed the presence of two gene clusters (orf46–47 and orf48–49), each one encoding a novel putative bacteriocin, i.e., garvicin AG1 (GarAG1; orf46) and garvicin AG2 (GarAG2; orf48), and their corresponding immunity proteins (orf47 and orf49). The chemically synthesised bacteriocins GarAG1 and GarAG2 presented inhibitory activity against pathogenic L. garvieae strains, with AG2 also being active against Listeria monocytogenes, Listeria ivanovii and Enterococcus faecalis. Genetic organisation, amino acid sequences and antimicrobial activities of GarAG1 and GarAG2 indicate that they belong to linear non-pediocin-like one-peptide class IId bacteriocins. Gram-positive bacteria that were sensitive to GarAG2 were also able to ferment mannose, suggesting that this bacteriocin could use the mannose phosphotransferase transport system (Man-PTS) involved in mannose uptake as a receptor in sensitive strains. Intriguingly, GarAG1 and GarAG2 were highly active against their own host, L. garvieae Lg-Granada, which could be envisaged as a new strategy to combat pathogens via their own weapons.
Collapse
|
3
|
McNeill J, Chew H, Andresen D, Muller D, Granger E, Wang LW. Coronary artery embolism and culture-negative endocarditis post Bentall's procedure. J Surg Case Rep 2021; 2021:rjab438. [PMID: 34631009 PMCID: PMC8496241 DOI: 10.1093/jscr/rjab438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 11/14/2022] Open
Abstract
Infective endocarditis is an important cause of morbidity and mortality, which classically presents with fevers and nonspecific symptoms. Afebrile infective endocarditis with negative blood cultures makes diagnosis more challenging and delays in treatment can occur increasing the likelihood of complications. The presence of prosthetic heart valves places patients at an increased risk of infective endocarditis and the case described below highlights the importance of considering this diagnosis even if classic clinical features such as fever and raised inflammatory markers are not present, as well as discussing an unusual complication of infective endocarditis; coronary artery embolism leading to myocardial infarction.
Collapse
Affiliation(s)
- Jared McNeill
- Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, NSW, Australia
| | - Hong Chew
- Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, NSW, Australia
| | - David Andresen
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, NSW, Australia
| | - David Muller
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia
| | - Emily Granger
- Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, NSW, Australia
| | - Louis W Wang
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia
| |
Collapse
|
4
|
Lee JY, Hyun M, Kim HA, Ryu SY. Infectious Spondylitis and Septicemia due to Lactococcus garvieae: a Literature Review of Non-Endocarditis Cases. Infect Chemother 2020:52.e63. [PMID: 33124212 DOI: 10.3947/ic.2019.0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/02/2019] [Indexed: 11/24/2022] Open
Abstract
Lactococci are Gram-positive cocci that occur in short chains or pairs and are traditionally considered to be of low virulence in human. Most species are not associated with human disease. There are few reports regarding Lactococcus isolation in humans and the clinical significance of this rarely-encountered genus is unknown. Here, we report a case of infectious spondylitis due to Lactococcus garvieae confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS). A 77-year-old man was admitted to our hospital with back pain that had lasted 5 days. He had diabetes mellitus, hypertension, and histories of pulmonary tuberculosis and endovascular aneurysm repair due to an abdominal aortic aneurysm. Magnetic resonance imaging of his spine revealed paravertebral enhancement on T8-9 and a compression fracture on the lower endplate of T8. On blood cultures, L. garvieae was identified by MALDI-TOF MS. To our knowledge, this is the first report of spondylitis caused by L. garvieae in Korea. In this context, we reviewed non-endocarditis cases due to L. garvieae reported in the English-language literature to summarize its clinical features and outcomes.
Collapse
Affiliation(s)
- Ji Yeon Lee
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Miri Hyun
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Hyun Ah Kim
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Seong Yeol Ryu
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Daegu, Korea.
| |
Collapse
|
5
|
Westberg M, Brekke H, Hermansen NO, Flatøy B. Late onset periprosthetic infection of the hip caused by the fish pathogen Lactococcus garvieae in a patient not associated with fish exposure. J Bone Jt Infect 2020; 5:106-109. [PMID: 32566447 PMCID: PMC7295644 DOI: 10.7150/jbji.43655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/25/2020] [Indexed: 11/05/2022] Open
Abstract
Lactococcus garvieae is a fish pathogen, rarely causing opportunistic infections in humans. There are only a few cases reported in the literature, mainly endocarditis, suggesting an association with raw fish consumption. We report a case of a periprosthetic hip infection successfully treated with a two-stage revision surgery.
Collapse
Affiliation(s)
- Marianne Westberg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Hanne Brekke
- Department of Medical Microbiology, Oslo University Hospital, Oslo, Norway
| | | | - Bernhard Flatøy
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
6
|
Rösch RM, Buschmann K, Brendel L, Schwanz T, Vahl CF. Lactococcus garvieae Endocarditis in a Prosthetic Aortic Valve: A Case Report and Literature Review. J Investig Med High Impact Case Rep 2020; 7:2324709619832052. [PMID: 31010322 PMCID: PMC6480988 DOI: 10.1177/2324709619832052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background. Lactococcus garvieae (LG) is a gram-positive coccus known to be a major pathogen in aqua farming, which is responsible for severe outbreaks. Its incidence in humans is extremely rare. Prior to 1985, all bacteria in the genus Lactococcus were included in the Streptococcus genus. The first human infection was documented in 1991, and since then, the relevance and clinical significance in humans has increased. Case Description. We present the clinical course of an LG endocarditis in a 78-year-old man who had a history of exertional dyspnea. The patient’s blood tests showed increased inflammation values, and a transesophageal ultrasound (TEE) showed a stenosis of the prosthetic aortic valve. Blood cultures were positive for LG, leading to a diagnosis of infective endocarditis. After 6 weeks of intravenous antibiotics and a prosthetic aortic valve replacement, the patient made a good recovery. Review of the Literature. After the first documented case in 1991 to 2018, 25 cases of LG endocarditis have been described in PubMed and MEDLINE. We reviewed all reported cases of LG endocarditis, commenting on predisposing risk factors, the course and outcome of the disease. Conclusion. LG endocarditis is a rare disease. Consumption of raw fish, abnormalities of the digestive tract, immune deficiency, and underlying cardiac conditions appear to be risk factors for an infective endocarditis due to LG. Improved determination techniques are likely to lead to a better and faster identification of the bacterium. This identification allows a faster and individualized therapy, which in turn affects the outcome.
Collapse
Affiliation(s)
| | | | - Lena Brendel
- 1 University Medical Center Mainz, Mainz, Germany
| | | | | |
Collapse
|
7
|
Cabrales HJ, García-Posada MJ, Porto-Valiente JM, Espinosa A, Narváez Y. Bacteriemia por Lactococcus garvieae: primer caso en Colombia. Infect 2020. [DOI: 10.22354/in.v24i3.865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Lactococcus garvieae es una causa inusual de bacteriemia. No existen guías diagnósticas y terapéuticas actuales disponibles para tratar las infecciones causadas por estos organismos. Con base en un informe de caso, proporcionamos una revisión de la literatura sobre bacteriemia causada por L. garvieae y destacamos los desafíos de diagnóstico y tratamiento de estas infecciones y las implicaciones para el manejo. Comunicamos el primer caso de bacteriemia por Lactococcus garvieae en Colombia.
Collapse
|
8
|
Malek A, De la Hoz A, Gomez-Villegas SI, Nowbakht C, Arias CA. Lactococcus garvieae, an unusual pathogen in infective endocarditis: case report and review of the literature. BMC Infect Dis 2019; 19:301. [PMID: 30943906 PMCID: PMC6446321 DOI: 10.1186/s12879-019-3912-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/17/2019] [Indexed: 12/14/2022] Open
Abstract
Background Lactococcus garvieae is an unusual cause of infective endocarditis (IE). No current diagnostic and therapeutic guidelines are available to treat IE caused by these organisms. Based on a case report, we provide a review of the literature of IE caused by L. garvieae and highlight diagnostic and treatment challenges of these infections and implications for management. Case presentation A 50-year-old Asian male with mitral prosthetic valve presented to the hospital with intracranial haemorrhage, which was successfully treated. Three weeks later, he complained of generalized malaise. Further work up revealed blood cultures positive for Gram-positive cocci identified as L. garvieae by MALDI-TOF. An echocardiogram confirmed the diagnosis of IE. Susceptibility testing showed resistance only to clindamycin. Vancomycin plus gentamicin were started as empirical therapy and, subsequently, the combination of ceftriaxone plus gentamicin was used after susceptibility studies were available. After two weeks of combination therapy, ceftriaxone was continued as monotherapy for six additional weeks with good outcome. Conclusions Twenty-five cases of IE by Lactococcus garvieae have been reported in the literature. Compared to other Gram-positive cocci, L. garvieae affects more frequently patients with prosthetic valves. IE presents in a subacute manner and the case fatality rate can be as high as 16%, comparable to that of streptococcal IE (15.7%). Reliable methods for identification of L. garvieae include MALDI-TOF, 16S RNA PCR, API 32 strep kit and BD Automated Phoenix System. Recommended antimicrobials for L. garvieae IE are ampicillin, amoxicillin, ceftriaxone or vancomycin in monotherapy or in combination with gentamicin.
Collapse
Affiliation(s)
- Alexandre Malek
- Department of Internal Medicine, Division of Infectious Diseases, UTHealth - McGovern Medical School, Houston, TX, USA
| | - Alejandro De la Hoz
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Cima Nowbakht
- Department of Internal Medicine, Division of Infectious Diseases, UTHealth - McGovern Medical School, Houston, TX, USA
| | - Cesar A Arias
- Department of Internal Medicine, Division of Infectious Diseases, UTHealth - McGovern Medical School, Houston, TX, USA. .,Center for Antimicrobial Resistance and Microbial Genomics (CARMiG), UTHealth - McGovern Medical School, Houston, TX, USA. .,Center for Infectious Diseases, UTHealth - School of Public Health, Houston, TX, USA. .,Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia. .,University of Texas Health Science Center at Houston (UTHealth), 6431 Fannin St. MSB 2.112, Houston, TX, 77030, USA.
| |
Collapse
|
9
|
Lim SM, Wong B, Cross GB, Merchant R. Lactobacillus garvieae endocarditis presenting with leg cramps. IDCases 2018; 13:e00427. [PMID: 30101072 DOI: 10.1016/j.idcr.2018.e00427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 11/22/2022] Open
Abstract
An 85-year-old man with a history of aortic valve replacement presented with lower limb cramps. He was initially diagnosed with degenerative disc disease, but was found to have Lactococcus garvieae infective endocarditis with septic embolic strokes causing a central poststroke pain syndrome. Cardiothoracic surgery was deemed too high risk and the patient completed 6 weeks of intravenous antimicrobials as well as prolonged inpatient rehabilitation. Lactococcus garvieae is an aquaculture pathogen which typically affects elderly and immunocompromised patients. Atypical presentations of endocarditis in the elderly can lead to delays in diagnosis.
Collapse
|
10
|
Gibello A, Galán-Sánchez F, Blanco MM, Rodríguez-Iglesias M, Domínguez L, Fernández-Garayzábal JF. The zoonotic potential of Lactococcus garvieae: An overview on microbiology, epidemiology, virulence factors and relationship with its presence in foods. Res Vet Sci 2016; 109:59-70. [DOI: 10.1016/j.rvsc.2016.09.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/13/2016] [Accepted: 09/16/2016] [Indexed: 01/10/2023]
|