Gemella morbillorum endocarditis of pulmonary valve:a case report

BACKGROUND: Pulmonary valve infective endocarditis is a rare finding for endocarditis. Infective endocarditis caused by Gemella morbillorum remains a scanty occurrence. CASE PRESENTATION: This is a case reported of a 28-year-old Chinese male with endocarditis caused by pulmonary valve infection of Gemella morbillorum associated with congenital ventricular septal defect, atrial septal defect and double-chambered right ventricle. The patient presented with fever, shortness of breath, progressively worsening exertional fatigue, dyspnea and weight loss for 3 months. The diagnosis was made with transthoracic echocardiogram, blood cultures, and post-operative pathology. The patient developed congestive heart failure and was managed with aggressive antibiotic therapy followed by surgery. He underwent replacement of the pulmonary valve with an aortic bioprosthetic valve, repair of ventricular septal defect and atrial septal defect, reconstruction of the right ventricular outlflow tract, and excision of vegetations. His postoperative recovery was uneventful. No bacteria were isolated from the excised tissues. He was asymptomatic without recurrence at 3-month follow-up. CONCLUSIONS: The rare pathogen such as Gemella morbillorum can be the cause of infective endocarditis and timely surgical repair is necessary if the infection is refractory or there is progression of congestive heart failure under antibiotic cover.