Letter to the EditorThe pitfall of coagulase-negative staphylococci: A case of Staphylococcus lugdunensis endocarditis
Introduction
Staphylococcus lugdunensis is a coagulase-negative staphylococcus that was first described by Freney et al. in 1988 [1]. It was named after Lyon (Latin adjective of Lugdunum), the French city where the organism was first isolated. S. lugdunensis is commonly found on the human skin and is a rare contaminant in cultures [2]. Although coagulase-negative staphylococci are generally considered nonpathogenic commensals in immunocompetent hosts or in the absence of indwelling foreign bodies, S. lugdunensis is a well-characterized exception due to its markedly aggressive nature [3]. S. lugdunensis is a relatively rare cause of endocarditis, but has been previously described as causing acute endocarditis with a high mortality rate [4].
In this report, we describe a case of native aortic and mitral valve endocarditis caused by S. lugdunensis that required emergency surgery, and discuss the virulent pathogenesis of S. lugdunensis.
Section snippets
Case report
We report a case of a 60-year-old woman who was transferred to our cardiovascular medicine department with a diagnosis of infectious endocarditis due to S. lugdunensis in March 2005. Her past medical history included hypertension, liver cirrhosis of unknown etiology, and a surgery for spinal dural arteriovenous fistula in 2002. At the end of February 2005, she caught a cold and ran a fever. On March 3, the patient was diagnosed with bronchitis and was admitted to a local hospital. At that time,
Discussion
Clinical manifestations of infections due to coagulase-negative staphylococci markedly differ from those of Staphylococcus aureus infections. Normally, the clinical picture is subtle and non-specific, and the clinical course is more subacute or even chronic without fulminant signs of infection. Coagulase-negative staphylococcal bacteremia is rarely life threatening, especially if treated promptly and adequately [3]. Nevertheless, S. lugdunensis is a well-characterized exception due to its
References (14)
- et al.
Pathogenesis of infections due to coagulase-negative staphylococci
Lancet Infect Dis
(2002) - et al.
Staphylococcus lugdunensis endocarditis
Lancet
(1989) - et al.
Staphylococcus lugdunensis endocarditis following lower extremity revascularization
Int J Cardiol
(2007) - et al.
Staphylococcus lugdunensis sp. nov. and Staphylococcus schleiferi sp. nov., two species from human clinical specimens
Int J Syst Bacteriol
(1988) - et al.
Occurrence of Staphylococcus lugdunensis in consecutive clinical cultures and relationship of isolation to infection
J Clin Microbiol
(1991) - et al.
Endocarditis due to Staphylococcus lugdunensis: report of 11 cases and review
Clin Infect Dis
(1993) - et al.
Hospital Clinic Endocarditis Study Group. Staphylococcus lugdunensis infective endocarditis: description of 10 cases and analysis of native valve, prosthetic valve, and pacemaker lead endocarditis clinical profiles
Heart
(2005)
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Multiple mycotic aneurysms reveal Staphylococcus lugdunensis endocarditis in a young patient
2011, Heart and Lung: Journal of Acute and Critical CareCitation Excerpt :Clinical manifestations of infections because of CNS are extremely different from those of Staphylococcus aureus.3 In most reported cases, the clinical presentation is subtle and nonspecific, and the clinical course is more subacute or even chronic, without fulminant signs of infection.3 In our patient, neurological complications were the mode of revelation of native valves endocarditis, without an obvious portal of entry.
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