Endocarditis Due to Vancomycin-Resistant Enterococccus gallinarum in a Patient with End-Stage Renal Failure: A Case Report

摘要

The first described vancomycin resistant enterococci (VRE) was about twenty years ago. Recently VRE have been reported by many clinics. However endocarditis due to VRE is still a rare entity and there are only a few cases reported in the literature. We are reporting a 59-year-old male patient with chronic renal failure who was on hemodialysis. He presented with a sudden onset of fever, tachycardia and respiratory distress. The performed echocardiography revealed vegetations on the mitral and aortic valves. As he was diagnosed to have infective endocarditis the patient was put on ampicillin and gentamicin therapy. He underwent an emergent mitral and aortic valve surgery due to ensued heart failure. While he was still on ampicillin and gentamicin therapy, E. gallinarum, which was resistant to vancomycin (MIC = 8 mg/L), was isolated from the surgical valve specimens and hence his antibiotic regime was switched to teicoplanin (MIC < 0.5 mg/L). 28 days after teicoplanin therapy the patient was discharged with free of symptoms and any complication. This patient is presented as an example for an endocarditis with an unusual type of enterococci.