A Case of Native Valve Infective Endocarditis Caused by Bacillus cereus

Dong Hyun Oh; Min Hyung Kim; Yong Chan Kim; Je Eun Song; Jin Young Ahn; Sang Hoon Han; Jun Yong Choi; Chang Oh Kim; Hyuk-Jae Chang; Dongeun Yong; Young Goo Song; Kyungwon Lee; June Myung Kim

doi:10.3947/ic.2012.44.4.310

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Oh, Kim, Kim, Song, Ahn, Han, Choi, Kim, Chang, Yong, Song, Lee, and Kim: A Case of Native Valve Infective Endocarditis Caused by Bacillus cereus

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(4): 310-314.

Published online: 31 August 2012

DOI: https://doi.org/10.3947/ic.2012.44.4.310

A Case of Native Valve Infective Endocarditis Caused by Bacillus cereus

Dong Hyun Oh¹, Min Hyung Kim¹, Yong Chan Kim¹, Je Eun Song¹, Jin Young Ahn¹, Sang Hoon Han^1,², Jun Yong Choi^1,², Chang Oh Kim^1,², Hyuk-Jae Chang^1,³, Dongeun Yong⁴, Young Goo Song^1,², Kyungwon Lee⁴, June Myung Kim^1,²

¹Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

²AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

³Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

⁴Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to Sang Hoon Han, M.D. Department of Internal medicine and AIDS Research Institute, Yonsei University College of medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-1991, Fax: +82-2-393-6884, shhan74@yuhs.ac

Received 16 January 2012 Revised 28 February 2012 Accepted 12 March 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bacillus cereus is a ubiquitous organism that often contaminates microbiological cultures but rarely causes serious infections in humans. It is the causative organism of infective endocarditis (IE), a disease typically associated with intravenous (IV) drug abusers. Thus, almost all reported cases have involved the tricuspid valve. We report a case of native mitral valve (MV) IE caused by B. cereus in a 54 year-oldman with moderate MV regurgitation but no apparent history of IV drug use. He presented with fever and dyspnea on exertion, symptoms which had been ongoing for 2 months. B. cereus infection was determined by blood culture examination. A transthoracic echocardiography revealed that mobile vegetations had attached to the MV. He was treated with IV antibiotics for a total of 6 weeks and received MV replacement surgery. He has maintained a good clinical recovery without complications since discharge.

Keywords: Infective endocarditis, Bacillus cereus, Native valve, Mitral valve, Non-intravenous drug abuser

Figures and Tables

Figure 1

Transthoracic echocardiography in the parasternal long axis view as observed upon admission (A) and on the 12th hospital day (B) which reveal two vegetations of 1.3×0.6 cm and 1.2×0.7 cm size attached on the anterior and posterior of the mitral valve leaflet, respectively.

LA, left atrium; LV, left ventricle.

Table 1

Clinical Characteristics for 17 Patients Reported with Bacillus cereus Endocarditis (modified from Thomas, et al.[5])

IVDA, intravenous drug abuser; ASD, atrial septal defect; PV, prosthetic valve; RHD, rheumatic heart disease; N/D, no data or data not accessible; Tx, treatment

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