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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Wilson, Anne Mcwilliams, Eric Storey, Anna |
| Description | Author Affiliation: Storey A ( Department of Internal Medicine, Conquest Hospital, The Ridge, St Leonards-on-Sea, East Sussex, UK.) |
| Abstract | A 79-year-old woman presented with fever, lethargy and weight loss. Clinically, the patient was confused, frail and had a systolic murmur. Her temperature was 38 °C and she remained persistently febrile. Initial investigations revealed neutrophilia with an elevated C reactive protein level. Multiple peripheral blood cultures grew Achromobacter xylosoxidans, a Gram-negative rod, which is a very rare cause of infection in patients who are immunocompetent. Subsequent transoesophageal echocardiography confirmed endocarditis with obvious vegetations on the mitral valve. The patient was treated with intravenous meropenem and cotrimoxazole in line with microbiology guidance. Surgical intervention in the form of mitral valve replacement was considered, but the patient was felt to be at prohibitive risk. After 6 weeks of intravenous antibiotics, a repeat transoesophageal echocardiogram showed no improvement in the mitral valve vegetation, which had increased in size. At this stage, her clinical course was complicated by major upper gastrointestinal bleeding requiring transfusion, multiorgan failure and ultimately death. |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Volume Number | 2010 |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Achromobacter Denitrificans Endocarditis, Bacterial Diagnosis Gram-Negative Bacterial Infections Mitral Valve Microbiology Anti-Bacterial Agents Therapeutic Use Bacteremia Drug Therapy Drug Therapy, Combination Echocardiography, Transesophageal Fatal Outcome Follow-Up Studies Infusions, Intravenous Thienamycins Trimethoprim-Sulfamethoxazole Combination Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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