A Case of Prosthetic Valve Endocarditis with Cerebral Hemorrhage Caused by Rothia mucilaginosa

Yeo-Jin Song1   Bongyoung Kim1   Young-eun Kim2   Yangsoon Lee2   Hyunjoo Pai1*   

1 Department of Internal Medicine, Hanyang University College of Medicine, Seoul,
2 Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul,

* Corresponding author: Tel: +82-2-2290-8356, Fax: +82-2-2298-9183, E-mail: paihj@hanyang.ac.kr

Abstract

Rothia spp. are aerobic, gram-positive cocci belonging to the family Micrococcaceae, and are a part of the normal microbial flora of the human oropharynx and upper respiratory tract. We present the first case of the prosthetic valve endocarditis with cerebral hemorrhage caused by Rothia mucilaginosa in South Korea. A 65-year-old man with a prosthetic aortic valve visited the outpatient clinic with a complaint of fever. R. mucilaginosa was identified in one among four sets of blood culture bottles obtained on the on day 30 of fever onset. Brain magnetic resonance imaging (MRI) showed multiple micro-hemorrhages suggesting septic emboli in both the hemispheres, corticomedullary junctions, and cerebellum. Rothia spp. should be considered as a possible pathogen in the cases of infective endocarditis with intracranial hemorrhage.

Figures & Tables

Fig. 1. Microbiological examinations. A. Rothia mucilaginosa Gram staining (×1,000) B. Whitish to grey Rothia mucilaginosa colonies grown on chocolate agar plate at 35℃ and 5% CO2.