Prosthetic valve/conduit infection caused by Cardiobacterium valvarum

Excerpt

In February 2009, a 28-year-old female was admitted to Northwestern Memorial Hospital in Chicago, Illinois, with reports of soaking night sweats over the prior 3 months, without associated fever or weight loss. The patient had a medical history significant for truncus arteriosus. She had initial corrective surgery in 1981 involving a right ventricle to pulmonary artery conduit with porcine pulmonic valve, as well as ventricular septal defect repair. She underwent conduit replacements in 1984 and 1994 with a porcine-valved dacron conduit, along with bilateral pulmonary arterioplasty in 1994. In late October 2008, the patient underwent dental cleaning, prior to which she took prophylactic amoxicillin, 2 g single oral dose. About 2 weeks after the dental cleaning, she developed drenching night sweats, which increased in frequency until the time of admission. Chest X-ray revealed cardiomegaly and findings consistent with prior surgeries. Urinalysis and urine culture were negative. Antimicrobials were not administered, and after 3 days with negative blood cultures, she was discharged. On day 4 of incubation, blood cultures became positive with gram-negative rods and she was readmitted for further evaluation and treatment. …