Endocardites à Rothia spp : étude rétrospective monocentrique et revue systématique de la littérature

Abstract : Context: Rothia endocarditis are rare and poorly understood diseases. Methods: single-center, 10-year retrospective study of Rothia endocarditis at the Caen university hospital and review of the literature. Results: since 2008, only one patient had infective Rothia dentocariosa endocarditis at Caen hospital, complicating a ventricular septal defect in a 21-year-old woman with tooth decay. The outcome was favourable within 6 weeks of amoxicillin after surgery. Including our patient, we found 51 different cases of Rothia spp endocarditis, respectively R.dentocariosa (55%), R.mucilaginosa (25%) and R.aeria (18%) were identified in the literature. The patients were mainly men (82%), 46-year-old in median, immunocompetent (80%), with pre-existing cardiac abnormalities (54%). They had a dental portal of entry in 42% and/or were intravenous drug users in 20% of cases. The affected valve was mostly native (86%), mitral (47%) or aortic (35%). The endocarditis was complicated in 56% of cases with neurological (61%), cardiovascular (43%) or embolic (18%) events. After treatment with a beta-lactam (76%), an aminoglycoside (36%) or a glycopeptide (29%), associated with surgery in 48% of cases, survival was 86%. Conclusions: Rothia spp endocarditis are rare and usually secondary to oral or dental portal of entry and complicating pre-existing cardiac disease. Their treatment is based on infusion of amoxicillin for at least 6 weeks associated with surgical treatment in half the cases.
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Frédéric Franconieri. Endocardites à Rothia spp : étude rétrospective monocentrique et revue systématique de la littérature. Médecine humaine et pathologie. 2018. ⟨dumas-02101094⟩

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