Jpn. J. Infect. Dis., 58 (5), 323-325, 2005

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Short Communication

Nosocomial Methicillin-Resistant Staphylococcus aureus Endocarditis with Splenic Abscess in a Pregnant Woman

Zulal Ozkurt*, Bilgehan Erkut1 Ayten Kadanali, Azman Ates1 and Ibrahim Yekeler2

Department of Clinical Bacteriology and Infectious Diseases and 1Department of Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum and 2Department of Cardiovascular and Thoracic Surgery, Siyami Ersek Hospital, Istanbul, Turkey

(Received January 17, 2005. Accepted August 17, 2005)


*Corresponding author: Mailing address: Saglik Sok, Gez Konutlari, No:4, Dadaskent, Erzurum, Turkey. Tel: +90 442 316 63 33 ext. 2025, Fax: +90 442 316 63 40, E-mail: zozkurt@atauni.edu.tr


SUMMARY: A 36-year-old, 7-week-gravida patient with catheter-related nosocomial infective endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) is presented in this paper. The patient was admitted to our hospital because of carbon monoxide intoxication. After 14 days, MRSA catheter-related bacteremia developed. The central venous catheter was immediately removed, and teicoplanin therapy was started. Because of persistent fever, leukocytosis, and high C-reactive protein values, endocarditis was suspected. A transesophageal echocardiogram revealed 19-mm vegetation on her mitral valve, confirming the diagnosis of endocarditis. Gentamicin and rifampicin were added to the therapy regimen, and the dose of teicoplanin was increased to 12 mg/kg-day. After 8 days, a splenic abscess was detected by ultrasonography. Vegetation excision, mitral valve replacement by open-heart surgery and splenectomy were performed in the same operation. Antibiotherapy was continued for 6 weeks after surgery, and the patientfs condition improved. The development of endocarditis could be prevented by proper clinical practices.


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