Status:
Ready to upload
Record number:
1296
Adverse Occurrence type:
MPHO Type:
Time to detection:
2 years
Alerting signals, symptoms, evidence of occurrence:
17 year old male with three week history of lethargy and night sweats of 3 weeks duration developing 2 years after aortic valve allograft replacement for congenital aortic stenosis. Was treated with ampicillin immediately before admission for a bronchopulmonary infection. History of dental treatment three months before illness with prophylactic antibiotic coverage. Cardiac echo showed sessile vegetation of AV with regurgitation. New diastolic murmur. No other clinical signs of bacterial endocarditis. Normal ESR and CRP. 7 of 12 blood cultures were positive for Cardiobacterium hominis. Heart valve excised and culture showed no growth. Antibiotic treatment and replacement with new AV allograft was successful. No evaluation of heart valve donor reported.
Demonstration of imputability or root cause:
Very unlikely to be related to use of a contaminated aortic valve allograft, but donor information and the condition of heart valve allograft prior to clinical use was not discussed. If the allograft had been contaminated by bacteria prior to use, signs and symptoms would have developed earlier. The long interval between implantation and evidence of bacterial infection of the valve strongly suggests exogenous acquisition of bacteria. Several similar cases of C. hominis infection of mechanical valves have been reported.
Imputability grade:
1 Possible
Groups audience:
Keywords:
Reference attachment:
Suggest references:
Currie, P.F., et al., Late aortic homograft valve endocarditis caused by Cardiobacterium hominis: a case report and review of the literature. Heart, 2000. 83(5): p. 579-81.
Note:
Very unlikely or possible? Ready to upload once taxonomy is sorted - Cardiobacterium (Evi)