Mycobacterial prosthetic valve endocarditis.

Abstract:

:Prosthetic valve endocarditis (PVE) due to mycobacteria is a rare but frequently fatal complication that may occur early after the surgical procedure, or even years later. Infection has been described with both mechanical and biologic valvular prosthesis. The most commonly implicated mycobacterial species belong to the rapid-grower group (M. chelonei, M. fortuitum, and M. abscessus) of nontuberculous mycobacteria (NTM). The source of infection in this context is thought to be nosocomial, likely related to preoperative or intraoperative contamination of the prosthesis by contact with aqueous solutions containing the organisms. These infections are difficult to diagnose because blood cultures are often negative. Clinically, it is important to recognize the possibility of NTM-PVE in the differential diagnosis of culture-negative patients who develop signs and symptoms of endocarditis, whether they present early or late in onset after the surgical procedure. These patients should be treated with surgical removal of the infected valve, followed by adequate antimicrobial therapy based on the susceptibility of the species isolated from the valve or perivalvular tissue culture. In a significant number of patients, however, an unstable hemodynamic condition ensues, precluding surgical intervention, and therefore leading to a high mortality rate.

journal_name

Curr Infect Dis Rep

authors

Bush LM,Paturi A,Chaparro-Rojas F,Perez MT

doi

10.1007/s11908-010-0108-1

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

257-65

issue

4

eissn

1523-3847

issn

1534-3146

journal_volume

12

pub_type

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