Infective Endocarditis Caused by Abiotrophia defectiva in a Pediatric Patient

Abstract

Abiotrophia defectiva is a nutritional defective streptococcus that is difficult to grow in routine culture media, is found in the oral mucosa, gastrointestinal and urogenital system flora and is a rare cause of infective endocarditis. An 11-year-old boy with underlying operated congenital heart defect presented with prolonged fever. Abiotrophia defectiva is yielded in the blood cultures taken properly with a pre-diagnosis of infective endocarditis. Although there was no vegetation or other finding of endocarditis on echocardiography, surgery decision was made because bacteria continued to grow in the blood culture under appropriate antibiotic treatment. During surgery, it was observed that the contegrapulmonic valved conduit was severely degenerated and calcified. A new contegrapulmonic valve conduit replacement was performed.

Serious complications occur more frequently in infective endocarditis caused by Abiotrophia defectiva compared to other etiogic agents of infective endocarditis. With this case, we wanted to emphasize that in Abiotrophia defectiva infective endocarditis, the possibility of antibiotic treatment failure and surgical procedure requirement is quite high.