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Bordetella holmesii Prosthetic Valve Endocarditis: A Case Report and Review

Bush, Larry M. MD, FACP*; Davidson, Erin BS; Daugherty, Johanna MD

Infectious Diseases in Clinical Practice: July 2012 - Volume 20 - Issue 4 - p 248–253
doi: 10.1097/IPC.0b013e318248f14f
Review Articles

Prosthetic valve endocarditis is a serious medical condition, which may lead to significant morbidity and potentially fatal end result. At times, diagnosis is difficult when echocardiographic modalities fail to detect the presence of vegetation or abnormality on the valve itself or adjacent cardiac tissues. In addition, both early- and late-onset diseases may, on occasion, involve unusual microorganisms that not only can be challenging to cultivate but also lack specific treatment guidelines. Bordetella holmesii, a relatively recent addition to the Bordetella genus, has rarely been associated with clinical infection, presenting most often as bacteremia, or less frequently, respiratory illness. Generally, individuals manifest mild disease when infected with these somewhat avirulent gram-negative coccobacilli. However, endocarditis has been diagnosed in 3 previously reported cases. Most of the patients with B holmesii infection have been young and immunocompromised, almost always as a result of anatomical or functional asplenia. We describe the first reported case of prosthetic valve endocarditis due to B holmesii, diagnosed in an elderly immunocompetent man; apropos, we review the pathogen B holmesii, including a summary of known previous infections and discuss its clinical manifestations, microbiologic characteristics, and potential treatment options.

Known to mostly cause mild disease, Bordetella holmesii most often presents clinically as bacteremia, with occasional patients also having respiratory illness. In most instances, infected patients are immunocompromised, with anatomical or functional asplenia being the most common undeerlying condition. Bush et al. describe the first case of prosthetic valve enodcarditis due to this rare pathogen. A propos this case, they review the clinical manifestations, microbiologic profile and treatment options for B. homesii.

From the *Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL; University of Miami-Miller School of Medicine at JFK Medical Center, Palm Beach County, FL, †University of Miami-Miller School of Medicine, Miami, FL and ‡Internal Medicine, University of Miami-Miller School of Medicine Affiliated Program at JFK Medical Center, Atlantis, Florida.

Correspondence to: Larry M. Bush, MD, FACP, Comprehensive Infectious Diseases, LLC, 5503 South Congress Ave, Suite 104, Atlantis, FL 33462. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2012 Lippincott Williams & Wilkins, Inc.