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conferenceseries
.com
Volume 7
Journal of Infectious Diseases & Therapy
Infectious Diseases & Endocrinology 2019
February 27-28, 2019
February 27-28, 2019 Tokyo, Japan
Infectious Diseases, Diabetes and Endocrinology
Global Experts Meeting on
Soo You Lee, J Infect Dis Ther 2019, Volume 7
DOI: 10.4172/2332-0877-C2-063
Use of daptomycin due to lactic acidosis complicated by linezolid for prosthetic valve endocarditis
due to vancomycin-resistant
Enterococcus faecium
: Case report
Soo You Lee
Sejong General Hospital, Republic of Korea
E
nterococci
have become common nosocomial pathogens and are currently the third-leading causes of nosocomial
bloodstream infection. Vancomycin-Resistant Enterocolli (VRE), mostly
Enterococcus faecium
, are increasingly involve,
especially in critical patients with co-morbid condition. The options for treatment of VRE have improved over the years with
the advent of oxazolidinone linezolid, the glycylcycline tigecycline and the lipopeptide daptomycin. Nonetheless, toxicities
my limit their use. We here report a case of VRE prosthetic valve endocarditis with daptomycin due to severe lactic acidosis
complicated by Linezolid. A 45 years old female, who had undergone prosthetic aortic valve replacement 15 years back, is
presented with cardiogenic shock. Chest X-ray showed pulmonary edema. Pannus formation on a Hancock II 21 mm aortic
valve prosthetis in the aortic position as depicted by transthoracic echocardiogram. Oliguria was developed and eGFR was
rise. She underwent continuous renal replacement therapy. Until waiting redo aortic valve replacement, abruptly fever was
developed. Transthoracic echocardiography showed vegetation at tricuspid valve. Urgent aortic valve replacement was done
without complication. Blood cultures grew
Enterocuccus faecium
, which was resistant to vancomycin but susceptible to linezolid
and daptomycin. However, tissue cultures showed no growth results. Treatment with intravenous Linezolid was initiated. Her
bacteremia initially cleared. After 16 days on treatment of linezolid, lactic acid was elevated up to 15 mmol/L. We switched
linezolid to daptomycin. Lactic acid was decreased to normal range after 8 days stopping linezolid. Severe lactic acidosis with
linezolid present barriers to effective treatment. Serial follow up of lactic acid during treatment with Linezolid is crucial to
management patients with VRE.
Biography
Soo Youn Lee has completed her Doctor of Medicine from Chosun University College of Medicine. She is the Director of ICU at Sejong General Hospital, Buchoen,
Republic of Korea. She has published 6 papers in reputed journals.
leesy@sejongh.co.kr