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Legionella micdadei prosthetic valve endocarditis

Klappenprothesenendokarditis durchLegionella micdadei

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Summary

Legionella usually causes pneumonia, but occasionally is in the differential diagnosis of “culture negative endocarditis” which sometimes involves prosthetic heart valves.Legionella prosthetic valve endocarditis is nearly always due toLegionella pneumophila and its clinical presentation is indistinguishable from other causes of prosthetic valve endocarditis. Diagnosis ofLegionella prosthetic valve endocarditis is by recovery of the organism from the blood, demonstration or isolation of the organism from the prosthetic heart valve, or by persistently highLegionella titers which are extremely elevated in prosthetic valve endocarditis compared toLegionella pneumonia. We believe this is the first case reported of prosthetic valve endocarditis caused byLegionella micdadei, and the first case ofLegionella prosthetic valve endocarditis with microscopic hematuria.

Zusammenfassung

Gelegentlich muß der PneumonieerregerLegionella in der Differentialdiagnose der „kulturnegativen Endokarditis“ berücksichtigt werden, die manchmal auch Klappenprothesen befällt. Die Klappenprothesenendokarditis wird bei Legionellenätiologie fast ausschließlich durchLegionella pneumophila verursacht; in ihrem klinischen Erscheinungsbild ist sie von Klappenprothesenendokarditiden anderer Genese nicht zu unterscheiden. Die Diagnose wird durch Erregernachweis im But, in der entfernten Klappe oder durch sehr hoheLegionella-Titer nachgewiesen, die im Vergleich zur Legionellenpneumonie extrem stark erhöht sind. Wir gehen davon aus, daß unsere Fallmitteilung die erste Publikation einer Klappenprothesenendokarditis durchLegionella micdadei und der erste Fall mit Mikrohämaturie ist.

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Authors and Affiliations

  1. Infectious Disease Division, Winthrop-University Hospital, 11501, Mineola, NY, USA

    D. Park M.D., A. Pugliese M.D. & B. A. Cunha M.D.

  2. the School of Medicine, SUNY at Stony Brook, Stony Brook, New York, USA

    D. Park M.D., A. Pugliese M.D. & B. A. Cunha M.D.

Authors
  1. D. Park M.D.
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  2. A. Pugliese M.D.
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  3. B. A. Cunha M.D.
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Park, D., Pugliese, A. & Cunha, B.A. Legionella micdadei prosthetic valve endocarditis. Infection 22, 213–215 (1994). https://doi.org/10.1007/BF01716708

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  • DOI: https://doi.org/10.1007/BF01716708

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