Endocarditis Due to Vancomycin-resistant Enterococcus faecium
Endocarditis Due to Vancomycin-resistant Enterococcus faecium
A 56-year-old man with diabetes mellitus and cadaveric renal transplantation had vancomycin-resistant Enterococcus faecium tricuspid valve endocarditis. Relapse followed 6 weeks of treatment with intravenous gentamicin and high-dose ampicillin. On the basis of previous data suggesting the potential for synergistic activity of quinupristin/dalfopristin plus high-dose ampicillin, therapy with this combination was administered for 63 days. Cure was achieved and later confirmed at 2-year follow-up.
The development of vancomycin-resistant Enterococcus faecium has increased the therapeutic challenge presented by enterococcal endocarditis, because prolonged bactericidal therapy is necessary for cure. We report a case of tricuspid valve endocarditis due to vancomycin-resistant E. faecium in an immunocompromised patient who was successfully treated with quinupristin/dalfopristin (Q/D) and high-dose ampicillin after unsuccessful gentamicin and high-dose ampicillin therapy.
A 56-year-old man with diabetes mellitus and cadaveric renal transplantation had vancomycin-resistant Enterococcus faecium tricuspid valve endocarditis. Relapse followed 6 weeks of treatment with intravenous gentamicin and high-dose ampicillin. On the basis of previous data suggesting the potential for synergistic activity of quinupristin/dalfopristin plus high-dose ampicillin, therapy with this combination was administered for 63 days. Cure was achieved and later confirmed at 2-year follow-up.
The development of vancomycin-resistant Enterococcus faecium has increased the therapeutic challenge presented by enterococcal endocarditis, because prolonged bactericidal therapy is necessary for cure. We report a case of tricuspid valve endocarditis due to vancomycin-resistant E. faecium in an immunocompromised patient who was successfully treated with quinupristin/dalfopristin (Q/D) and high-dose ampicillin after unsuccessful gentamicin and high-dose ampicillin therapy.
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