Identification of Streptococcus gallolyticus subsp. macedonicus as the etiological agent in a case of culture-negative multivalve infective endocarditis by 16S rDNA PCR analysis of resected valvular tissue

J Heart Valve Dis. 2008 Sep;17(5):589-92.

Abstract

Today, PCR using broad-range primers is being used increasingly to detect pathogens from resected heart valves. Herein is described the first case of multivalve infective endocarditis where 16S rDNA PCR was used to detect a single pathogen from two affected valves in a 61-year-old man. Triple heart valve replacement was required despite six weeks of appropriate antimicrobial therapy. The organism was confirmed as Streptococcus gallolyticus subsp. macedonicus, a member of the 'S. equinus/S. bovis' complex. To date, only one report has been made of human infection due to this organism. This may be due to the limited resolution of the routine diagnostic methods used and/or as a consequence of the complex nomenclature associated with this group of organisms.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteriological Techniques*
  • DNA, Ribosomal / genetics*
  • Endocarditis, Bacterial / microbiology*
  • Endocarditis, Bacterial / surgery
  • Heart Valve Diseases / microbiology
  • Heart Valve Diseases / surgery
  • Heart Valve Prosthesis Implantation
  • Heart Valves / microbiology
  • Heart Valves / surgery
  • Humans
  • Male
  • Middle Aged
  • Phylogeny
  • Polymerase Chain Reaction*
  • Streptococcal Infections / microbiology*
  • Streptococcal Infections / surgery
  • Streptococcus / genetics*
  • Streptococcus bovis / genetics
  • Streptococcus equi / genetics

Substances

  • DNA, Ribosomal