Case report: A prosthetic valve endocarditis caused by Legionella bozemanae in an immunocompetent patient

Mai Sasaki Aanensen Fraz; Gry Dahle; Kirsten Margrete Skaug; Sophie Jarraud; Stephan Frye; Jørgen Vildershøj Bjørnholt; Ingvild Nordøy

doi:10.3389/fmed.2022.1055465

Case report: A prosthetic valve endocarditis caused by Legionella bozemanae in an immunocompetent patient

Front Med (Lausanne). 2022 Nov 3;9:1055465. doi: 10.3389/fmed.2022.1055465. eCollection 2022.

Authors

Mai Sasaki Aanensen Fraz^{1

2

3}, Gry Dahle⁴, Kirsten Margrete Skaug¹, Sophie Jarraud⁵, Stephan Frye¹, Jørgen Vildershøj Bjørnholt^{1

6}, Ingvild Nordøy^{7

8}

Affiliations

¹ Department of Microbiology, Oslo University Hospital, Oslo, Norway.
² Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway.
³ Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.
⁴ Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway.
⁵ National Reference Centre for Legionella, Institute of Infectious Agents, Hospices Civils de Lyon, Lyon, France.
⁶ Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ Section for Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway.
⁸ Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.

Abstract

Extrapulmonary infections with Legionella species are rare, but important to acknowledge. We report a case of infective endocarditis (IE) with Legionella bozemanae in a 66-year-old immunocompetent man with an aortic homograft. The diagnosis was made by direct 16S rRNA gene amplification from valve material, confirmed by a targeted Legionella-PCR in serum and the detection of L. bozemanae specific antibodies. To our knowledge, this is the first confirmed case of IE with L. bozemanae as causative pathogen. The infected aortic prosthesis was replaced by a homograft, and the patient was successfully treated with levofloxacin and azithromycin for 6 weeks.

Keywords: Legionella bozemanae; Legionella bozemanii; blood culture negative endocarditis; endocarditis; molecular diagnostic techniques; prosthetic valve endocarditis (PVE).

Publication types

Case Reports