The Long CoN(S): A Case of Staphylococcus lugdunensis Endocarditis With Cerebral and Coronary Embolism

Jose Kuzhively, Sanjay A. Patel, Hrudya Abraham


Staphylococcus lugdunensis is a coagulase-negative staphylococcus, which in humans can cause virulent infections frequently attributable to Staphylococcus aureus including superficial skin/soft tissue infections, infective endocarditis, osteomyelitis and endophthalmitis. A 61-year-old male with history of recent fixation of C1-C2 neck fracture, presented with sudden onset of right-sided weakness and fever. Examination revealed dense hemiplegia with UMN facial palsy of right side, and a pan-systolic murmur in the mitral area, radiating to the axilla. He had an elevated troponin-I of 18.8 ng/mL with right bundle branch block on EKG. Echocardiogram revealed mobile vegetation on the anterior leaflet of the mitral valve with ejection fraction of 55% and no regional wall motion abnormality. He continued to have persistent high-grade fevers in spite of appropriate antibiotic therapy and blood cultures were persistently positive for S. lugdunensis for 5 days. He developed weakness of his left side after 2 weeks of hospital admission and MRA revealed left carotid dissection and complete occlusion of the right middle cerebral artery distal to the M1 segment which was embolic in nature. The frequency of S. lugdunensis infection is underappreciated and biofilm formation plays a major role in the pathogenesis. This is the first reported case of S. lugdunensis endocarditis complicated by NSTEMI from coronary embolism and simultaneous stroke from cerebral embolism. Due to the early, frequent and fatal complications from S. lugdunensis bacteremia, we might have to consider early surgical intervention in the absence of class I or IIa recommendation.

J Med Cases. 2014;5(10):535-537


Endocarditis; Staphylococcus lugdunensis; Vegetation; Stroke; Myocardial infarction

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.