. 2021 Jul 23;14(7):e242093. doi: 10.1136/bcr-2021-242093

Table 2.

Reported cases of Gemella endocarditis

Authors reported	Age/gender	Risk factors for endocarditis	Presentation	Comorbidities	Valves involved	Antimicrobial therapy	Valve replacement	Survival outcome
Bell and McCartney,1992²²	19/M	IVDU—heroin, buprenorphine; saliva inoculation of venipuncture sites	2 weeks of malaise, nights sweats, intermittent fever	Hepatitis B infection	Tricuspid valve	Flucloxacillin, benzylpenicillin and gentamicin	No	Alive
Kerr et al, 1994²³	29/F	HOCM, recent wisdom teeth extraction	Persistent lethargy, flu-like symptoms, night sweats, dry cough	Not reported	Non-valvular	Benzylpenicillin and gentamicin; became sensitised to penicillin and switched to oral erythromycin and oral rifampicin	No	Alive
Terada et al, 1994²⁴	64/M	Dental caries	Low-grade fever, nocturnal dyspnoea	Not reported	Mitral and aortic valve	Penicillin	Yes, aortic and mitral valve replacement	Alive
Martin, Wright and Jones, 1995²⁵	75/M	Childhood rheumatic fever	Weight loss, lethargy	Not reported	Mitral valve	Benzylpenicillin and gentamicin; developed rash and switched to rifampin and erythromycin	No	Alive
Lopez-Dupla et al²¹	73/F	Colonic adenomatous polyps in rectum; adenocarcinoma in situ in transverse colon	3 months of anorexia, asthenia, malaise, fever, weight loss	Not reported	Mitral and aortic valve	Benzylpenicillin and gentamicin	Yes, aortic and mitral valve replacement	Deceased during surgery
Vasishtha and Sood, 1996²⁶	2/F	Single ventricle, transposition of the great arteries, pulmonic stenosis who underwent Fontan procedure	Fever and respiratory failure after Fontan surgery; developing septic shock	Down syndrome	Non-valvular	Vancomycin, ceftazidime, amikacin	No	Deceased. multisystem organ failure
Nandakumar and Raju, 1997²⁷	71/M	Chronic gingivitis and extensive dental caries; villous adenoma with severe atypia	Pulmonary infiltrates, acute onset fever, left lower lobe infiltrate, pleural effusion, weight loss, anaemia, renal insufficiency	ETOH liver disease	Tricuspid valve	Penicillin	No	Alive
Farmaki et al, 2000²⁸	9/F	Dental caries and periodontal disease with multiple recent dental procedures	6 weeks of intermittent fever	Not reported	Mitral valve	Penicillin and gentamicin	No	Alive
Purcell et al, 2001²⁹	12/F	Congenital heart disease (mitral stenosis, VSD, PDA) repaired at 6 months	Cough, fatigue, dec appetite; no fever	Not reported	Mitral valve	Vancomycin then transitioned to gentamicin and penicillin	No	Alive
Akiyama et al, 2001³⁰	55/M	Aortic regurgitation; prior endocarditis; previous aortic valve replacement; dental caries	Persistent fever, nocturnal dyspnoea	DM2, hepatitis B infection	Aortic valve	Cefotiam then transitioned to tobramycin, cefmetazole, fosfomycin	Yes, aortic valve replacement	Alive
Woo et al¹³	66/M	Not reported	1 month of abdominal and low back pain	Abdominal aortic aneurysm	Mitral and aortic valve	Penicillin, netilmicin	No	Alive
Zakir et al, 2004³¹	44/M	IVDU, prosthetic heart valve, recent mitral valve replacement	Pleuritic chest pain, dyspnoea, fever, chills	HIV	Bioprosthetic mitral valve and aortic valve	Ceftriaxone and gentamicin	Met criteria, but deferred due to active IVDU	Alive
Gimigliano et al, 2005³²	10/F	Transposition of the great arteries, an interventricular septal defect and aortic coarctation	Nocturnal fevers	Not reported	Mitral and aortic valve	Vancomycin and gentamicin	No	Alive
Kofteridis et al⁵	46/M	Recent dental procedure, poor ulcerative gingivitis	Fever, headache, vomiting, progressive confusion	Aneurysmal dilation of the ascending aorta with moderate aortic regurgitation	Aortic valve	Penicillin and gentamicin then transitioned to vancomycin	Yes, aortic valve replacement	Alive
Kofteridis et al⁵	53/M	Previous infective endocarditis	Persistent fever, sweats, myalgias	Not reported	Mitral valve	Penicillin and gentamicin then transitioned to vancomycin	No	Alive
Murai et al, 2006³³	53/M	Dental caries	1 week of high fevers	Not reported	Aortic valve	Cefotiam then transitioned to ampicillin and gentamicin	Yes, aortic valve replacement	Alive
Al-Hujailan et al, 2007³⁴	37/M	Bicuspid aortic valve with prior prosthetic valve replacement	10 days of sweats and chills	Not reported	Aortic valve	Vancomycin, gentamicin, rifampicin; vancomycin later switched to penicillin	No	Alive
Zheng et al, 2008³⁵	67/M	Aortic regurgitation, aortic syphilis; poor dentition	3 days of chills and rigours	HTN, ESRD on haemodialysis	Mitral and aortic valve	Ampicillin and gentamicin	Deceased prior to surgery	Deceased, multisystem organ failure
Chekakie et al., 2009³⁶	44/M	Bicuspid aortic valve with prior prosthetic valve replacement	Dyspnoea and decreased urine output	Cardiomyopathy with EF 15% with defibrillator placement	Aortic valve	Vancomycin, gentamicin, rifampin and switched to ampicillin and gentamicin then later switched to imipenem and metronidazole to treat E. coli bacteraemia and clostridium difficile	Yes, aortic valve replacement	Deceased, multisystem organ failure and LVAD related bleeding
Taimur et al, 2010³⁷	31/F	Bicuspid aortic valve, aortic regurgitation, repair of large aortic arch aneurysm	1 month of fever, exertional dyspnoea, myalgias, oedema, anorexia	Not reported	Mitral and aortic valve	Amikacin, ceftriaxone, vancomycin then transitioned to ceftriaxone and gentamicin	No	Alive
Massoure et al, 2010³⁸	22/M	Dental caries and periodontitis	Fever and dyspnoea	Tobacco use, khat chewer	Aortic valve	Amoxicillin and gentamicin	Deceased prior to surgery	Deceased, multisystem organ failure
Carano et al, 2010³⁹	18/F	Oral piercing on lower lip	Heart failure and recurrent fever	Not reported	Mitral valve	Penicillin	Yes, mitral valve replacement	Alive
Hull, 2010⁴⁰	87/M	Mitral regurgitation with ruptured chordae	5 days of confusion, cough, nausea, diarrhoea; 20 lbs weigh loss over 2 months	Atrial fibrillation	Mitral valve	‘Broad spectrum antibiotics’	Considered, but deemed a poor candidate	Alive
Godinho et al, 2013⁴¹	72/M	Aortic valve disease, recent endoscopies	Fever, abdominal pain, decompensated heart failure	Iron deficiency anaemia, hypertension	Aortic, mitral and tricuspid valve	Vancomycin and gentamicin	Yes, aortic and mitral valve replacement; tricuspid valve annuloplasty	Alive
Ural et al¹⁸	67/M	Recent EGD, colonoscopy	Anaemia, fever, fatigue, failure to thrive	Not reported	Aortic valve	Ampicillin-sulbactam and gentamicin then transitioned to vancomycin and meropenem	Yes, aortic valve replacement	Alive
Agrawal et al, 2014⁴²	‘Middle-aged man’	Atrial septal defect	Exertional fatigue and dyspnoea	Not reported	Pulmonary valve	Not reported	Yes, pulmonary bioprosthetic valve and patch closure of ASD	Alive
Kolhari et al, 2014⁴³	34/M	Recent dental extraction	2 weeks of low-grade fever, lower extremity oedema, dyspnoea on exertion	Hypertrophic cardiomyopathy	Mitral valve	Penicillin and levofloxacin	Yes, mitral valve replacement	Alive
Shahani, 2014⁴⁴	73/M	Aortic valve replacement, dental caries	5 days of fever and lower extremity oedema	Coronary artery disease, CABG, diabetes, hyperlipidaemia	Aortic valve	Penicillin and gentamicin	Yes, aortic valve replacement	Alive
Constantinos and Marios, 2015⁴⁵	80/F	Prior aortic valve replacement	2 weeks of fever and chest pain	Hypertension, diabetes	Tricuspid valve	Ceftriaxone and gentamicin	No	Alive
Rosa et al¹⁵	72/M	Prior CABG	Dyspnoea, dry cough, fever, anorexia, >10% weight loss over past 30 days	Hypertension, diabetes, peripheral arterial disease	Mitral valve	Ceftriaxone, gentamicin then transitioned to penicillin and gentamicin	Yes, mitral valve replacement	Deceased, during surgery
Shinha, 2017⁴⁶	37/M	IVDU	1 month of fever, chills, fatigue	Not reported	Aortic valve	Not reported	Not reported	Not reported
Li et al, 2017⁷	28/M	Congenital VSD, ASD and double chambered right ventricle	3 months of fever, chills, dyspnoea, decreasing exertional capacity, weight loss	Previous admission for bilateral pneumonia	Pulmonary valve	Ceftriaxone and then later added vancomycin	Yes, pulmonary and aortic valve replacement; closure of VSD and ASD, reconstruction of RVOT, excision of vegetations	Alive
Kumar et al, 2017⁴⁷	12/F	None	Fevers, chills, weight loss, palpitations, night sweats	None	Mitral valve	Vancomycin, gentamicin, penicillin	Offered mitral valve replacement, but family refused	Alive

ASD, Atrial Septal Defect; CABG, Coronary Artery Bypass Graft; DM2, Type 2 Diabetes Mellitus; EF, Ejection Fraction; EGD, Esophagogastroduodenoscopy; ESRD, End-Stage Renal Disease; ETOH, Alcohol; HOCM, Hypertrophic Obstructive Cardiomyopathy; HTN, Hypertension; IVDU, Intravenous Drug Use; LVAD, Left Ventricular Assist Device; PDA, Patent Ductus Arteriosus; VSD, Ventricular Septal Defect.