Relapsing tricuspid valve endocarditis by multidrug-resistant Pseudomonas aeruginosa in 11 years: tricuspid valve replacement with an aortic valve homograft

Journal of Cardiothoracic Surgery

Ki-Bong Kim³  Eui-Chong Kim²  Dong Ki Kang²  Seung-Pyo Lee¹  Hyoung Woo Chang³  Min-Seok Kim³ 

[1] Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu 110-744, Seoul, Korea;Department of Laboratory Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu 110-744, Seoul, Korea;Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu 110-744, Seoul, Korea

关键词: Tricuspid valve surgery;    Prosthesis;    Endocarditis;   

Others  :  1214008
DOI  :  10.1186/s13019-015-0287-9

 received in 2015-01-31, accepted in 2015-05-29,  发布年份 2015

【 摘 要 】

Eleven years ago, a 27-year-old non-drug abuser woman was admitted to the hospital due to a burn injury. During the treatment, she was diagnosed with tricuspid valve infective endocarditis caused by multi-drug resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa). She underwent tricuspid valve replacement (TVR) using a bioprosthetic valve, followed by 6 weeks of meropenem antibiotic therapy. Ten years later, she was again diagnosed with prosthetic valve infective endocarditis caused by MDR P. aeruginosa. She underwent redo-TVR with a bioprosthetic valve and was treated with colistin and ciprofloxacin. Ten months later, she was again diagnosed with prosthetic valve infective endocarditis with MDR P. aeruginosa as a pathogen. She underwent a second redo-TVR with a tissue valve and was treated with colistin. Two months later, her fever recurred and she was again diagnosed with prosthetic valve infective endocarditis caused by MDR P. aeruginosa. She eventually underwent a third redo-TVR using an aortic valve homograft and was discharged from the hospital after additional 6 weeks’ of antibiotic therapy. All the strains of P. aeruginosa isolated from each event of infective endocarditis were analyzed by repetitive deoxyribonucleic acid sequence-based polymerase chain reaction (rep-PCR) deoxyribonucleic acid (DNA) strain typing to determine the correlation of isolates. All of the pathogens in 11 years were similar enough to be classified as the same strain, and this is the first case report of TVR using an aortic valve homograft to treat relapsing endocarditis.

【 授权许可】

   
2015 Kim et al.

【 图 表 】

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