Abstract
Infective endocarditis (IE) remains a prevalent disease with a high rate of morbidity
and mortality. Recent changes have been noted in the profile of causative microorganisms.
In this report, we describe a case of Gemella-related endocarditis and review the related literature. Our patient was an 81-year-old
man who presented with dyspnea and fatigue. His initial examination revealed a new
systolic murmur. Echocardiogram revealed moderate mitral regurgitation with 1-cm mass
on the anterior mitral leaflet, and blood cultures grew Gemella haemolysans. Penicillin and gentamicin were initiated, and workup for possible source
was positive for a colonic polyp with high-grade dysplasia. The patient subsequently
developed cardiogenic shock and severe pulmonary edema. Comfort care measures were
initiated, and he passed away thereafter. We reviewed PubMed for cases of Gemella-related endocarditis. We found 65 documented cases and added our patient’s case to
the analysis. Seventy-two percent of the cases occurred in men. The mean age was 51
years and 42% of the patients were older than 60 years. Fever was the most common
presenting symptom and most of the cases presented subacutely. The mitral valve was
the most affected site and 50% of the patients required surgical intervention. G.
morbillorum was the most common subtype and a total of four cases were found to be
associated with colorectal neoplasm. As a conclusion, Gemella species rarely cause IE. The absence of a clear source of bacteremia warrants further
evaluation for a gastrointestinal source. The infection can be destructive and must
be promptly treated to avoid complications.
morbillorum Key messages: Gemella endocarditis is a serious infection with significant morbidity and mortality. It
must be promptly treated to avoid further complications.
Keywords
Endocarditis - Gemella haemolysans - mitral - regurgitation
