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Rhizobium radiobacter Endocarditis in an Intravenous Drug User: Clinical Presentation, Diagnosis, and Treatment.
Ann Vasc Surg 2016; 35:206.e9-206.e11AV

Abstract

Rhizobium radiobacter, a soil-based organism, is not, usually, pathogenic unless in the immunecompromised. Endocarditis, in the immunocompromised, is a typical presentation generally as a result of catheter-based infections. We describe the presentation of R. radiobacter prosthetic valve endocarditis and the inherent challenges in its presentation and diagnosis. A patient presented with acute limb ischemia secondary to R. radiobacter-mediated endocarditis and subsequent thromboembolization of the distal superior femoral and proximal popliteal arteries in the left lower limb. He underwent an uneventful thrombolectomy that restored blood flow distal to the occlusion and restored the patency of the affected arteries. Postoperatively, the patient maintained several unexplained febrile episodes. Blood cultures remained negative for infection. A cardiac work-up demonstrated the presence of vegetative growth on the prosthetic mitral and native aortic valves. Histopathologic analysis of the extracted thrombus confirmed the presence of R. radiobacter. On further history, it was elucidated that the patient was an intravenous drug user who routinely stored drug paraphernalia in plant beds. The patient recovered uneventfully after Piptazobactam was administered. R. radiobacter, and similarly other soil-based pathogens, should be considered as a potential source of endocarditic infection and thromboembolization in patients who similarly describe a history of intravenous drug use.

Authors+Show Affiliations

Department of Surgery, School of Medicine, University of Queensland, Brisbane, QLD, Australia; Department of Trauma, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia. Electronic address: bilal.zahoor@uqconnect.edu.au.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27239001

Citation

Zahoor, Bilal A.. "Rhizobium Radiobacter Endocarditis in an Intravenous Drug User: Clinical Presentation, Diagnosis, and Treatment." Annals of Vascular Surgery, vol. 35, 2016, pp. 206.e9-206.e11.
Zahoor BA. Rhizobium radiobacter Endocarditis in an Intravenous Drug User: Clinical Presentation, Diagnosis, and Treatment. Ann Vasc Surg. 2016;35:206.e9-206.e11.
Zahoor, B. A. (2016). Rhizobium radiobacter Endocarditis in an Intravenous Drug User: Clinical Presentation, Diagnosis, and Treatment. Annals of Vascular Surgery, 35, pp. 206.e9-206.e11. doi:10.1016/j.avsg.2016.01.041.
Zahoor BA. Rhizobium Radiobacter Endocarditis in an Intravenous Drug User: Clinical Presentation, Diagnosis, and Treatment. Ann Vasc Surg. 2016;35:206.e9-206.e11. PubMed PMID: 27239001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rhizobium radiobacter Endocarditis in an Intravenous Drug User: Clinical Presentation, Diagnosis, and Treatment. A1 - Zahoor,Bilal A, Y1 - 2016/05/27/ PY - 2015/10/06/received PY - 2016/01/08/revised PY - 2016/01/18/accepted PY - 2016/5/31/entrez PY - 2016/5/31/pubmed PY - 2017/1/24/medline SP - 206.e9 EP - 206.e11 JF - Annals of vascular surgery JO - Ann Vasc Surg VL - 35 N2 - Rhizobium radiobacter, a soil-based organism, is not, usually, pathogenic unless in the immunecompromised. Endocarditis, in the immunocompromised, is a typical presentation generally as a result of catheter-based infections. We describe the presentation of R. radiobacter prosthetic valve endocarditis and the inherent challenges in its presentation and diagnosis. A patient presented with acute limb ischemia secondary to R. radiobacter-mediated endocarditis and subsequent thromboembolization of the distal superior femoral and proximal popliteal arteries in the left lower limb. He underwent an uneventful thrombolectomy that restored blood flow distal to the occlusion and restored the patency of the affected arteries. Postoperatively, the patient maintained several unexplained febrile episodes. Blood cultures remained negative for infection. A cardiac work-up demonstrated the presence of vegetative growth on the prosthetic mitral and native aortic valves. Histopathologic analysis of the extracted thrombus confirmed the presence of R. radiobacter. On further history, it was elucidated that the patient was an intravenous drug user who routinely stored drug paraphernalia in plant beds. The patient recovered uneventfully after Piptazobactam was administered. R. radiobacter, and similarly other soil-based pathogens, should be considered as a potential source of endocarditic infection and thromboembolization in patients who similarly describe a history of intravenous drug use. SN - 1615-5947 UR - https://www.unboundmedicine.com/medline/citation/27239001/Rhizobium_radiobacter_Endocarditis_in_an_Intravenous_Drug_User:_Clinical_Presentation_Diagnosis_and_Treatment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(16)30365-X DB - PRIME DP - Unbound Medicine ER -