Flavobacterium Infection as a Cause of Bacterial Endocarditis

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Abstract
A 66-year-old man was hospitalized because of prolonged fever, incompletely controlled by several intermittent courses of antimicrobial therapy, and the picture of septicemia and probable endocarditis. Several blood cultures showed rapid growth of a Flavobacterium, sensitive to novobiocin and slightly sensitive to chloramphenicol. Despite vigorous treatment with these and other antibiotics, cardiac and supportive therapy, the patient died within 11 days. Necropsy revealed cardiac hypertrophy and scarring, vegetations attached to the calcified aortic valve, rupture of a mycotic aneurysm of an aortic cusp, with myocardial abscess. The kidneys showed sclerotic changes and interstitial round cell infiltration. Flavobacterium was isolated from the vegetations, the myocardial abscess, and the spleen. The organism recovered from the blood stream and the necropsy specimens differed in some respects from previously described species of Flavobacterium and was tentatively designated as Flavobacterium sp. K4. Its biochemical and other characteristics are reported in detail. Genitourinary tract infections and instrumentations are the most common sources of gram-negative septicemias. Failure to isolate Flavobacterium from this patient''s urine does not rule out this possibility since antecedent chemotherapy may have eliminated the organism from his genitourinary tract but not from the cardiac vegetations.

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