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J Thorac Cardiovasc Surg 2007;134:1579-1580
© 2007 The American Association for Thoracic Surgery

Brief Communication

Fulminant endocarditis caused by Streptobacillus moniliformis in a young man

Markus Kondruweit, MDa, Michael Weyand, MDa, Faidi Omar Mahmoud, MDa, Walter Geissdoerfer, PhDb, Christoph Schoerner, MDb, Dieter Ropers, MDc, Stephan Achenbach, MDc, Thomas Strecker, MDa,*

a Center of Cardiac Surgery, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany
b Institute of Clinical Microbiology, Friedrich-Alexander-University, Immunology and Hygiene, Erlangen-Nuremberg, Germany
c Department of Cardiology, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany.

Received for publication July 6, 2007; accepted for publication August 10, 2007.

* Address for reprints: Thomas Strecker, MD, Center of Cardiac Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany. (Email: thomas.strecker@herz.imed.uni-erlangen.de).

The first 20% of the full text of this article appears below.

Rat bite fever caused by Streptobacillus moniliformis is a very rare infectious disease and is characterized by the abrupt onset of fever, arthralgias, polyarthritis, and skin rash. Manifestation as acute endocarditis is extremely uncommon. Here we present the successful repair of massive endocarditis with giant floating vegetations on a degenerated, insufficient aortic valve. Two months after surgery, echocardiography showed almost normal left and right ventricular function with a well-functioning aortic valve prosthesis.

Clinical Summary

A 29-year-old farmer with a history of fever, dyspnea, dizziness, and increasing somnolence was referred to our hospital. He reported having been injured on his right hand 2 weeks earlier and a feeling of progressive lethargy and weakness for the week before coming to our clinic. A transesophageal echocardiogram revealed endocarditis with giant floating vegetations on a degenerated, insufficient aortic valve and a large perivalvular abscess cavity (Figure 1, A). Left ventricular function was highly impaired, with an ejection fraction of 20%. An . . . [Full Text of this Article]






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