{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:21:15Z","timestamp":1785432075454,"version":"3.56.0"},"reference-count":37,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:sec>\n                      <jats:title>Background<\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">Granulicatella adiacens<\/jats:italic>\n                        is a fastidious Gram-positive coccus and is a rare but recognized cause of infective endocarditis. Infective endocarditis during pregnancy is uncommon but carries substantial maternal and fetal risk. Plasma metagenomic analysis of microbial cell-free DNA has emerged as a complementary diagnostic tool in culture-negative infections.\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Case Summary<\/jats:title>\n                      <jats:p>\n                        We describe a 35-year-old pregnant woman with known mitral valve prolapse who presented at 21 weeks of gestation with an acute ischemic stroke. Initial etiological work-up, including transesophageal echocardiography, was unremarkable. Ten days later, she re-presented with left-arm pain and neurologic symptoms. Repeat echocardiography revealed multiple mitral vegetations compatible with infective endocarditis. Despite multiple sets of prolonged-incubation blood cultures and extensive serological testing, all microbiological investigations remained negative. Empirical intravenous ceftriaxone was initiated based on the working diagnosis of HACEK endocarditis. A plasma metagenomic cell-free DNA test ultimately identified\n                        <jats:italic toggle=\"yes\">G. adiacens<\/jats:italic>\n                        , which was suspected to have entered the body through dental treatment received a few weeks earlier. Ceftriaxone was continued given the favorable clinical response, with vegetation resolution, troponin decline, and uncomplicated term delivery of a healthy infant.\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Conclusion<\/jats:title>\n                      <jats:p>This case illustrates the diagnostic challenges of culture-negative infective endocarditis in pregnancy and underscores the value of plasma microbial cell-free DNA sequencing as a complementary tool when conventional methods fail. It also emphasizes the need to repeat echocardiography when clinical suspicion remains high and raises the question of antibiotic prophylaxis for high-risk dental procedures in pregnant women with underlying valvular heart disease.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/asmcr.00237-25","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T14:00:43Z","timestamp":1771941643000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["<i>Granulicatella adiacens<\/i>\n                    infective endocarditis in pregnancy: diagnostic contribution of metagenomic sequencing\u2014a case report"],"prefix":"10.1128","volume":"2","author":[{"given":"Aude","family":"Vasselin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Agents, CHU Brest","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Scavazzin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Agents, CHU Brest","place":["Brest, France"]},{"name":"Univ Brest, Inserm, EFS, UMR 1078, GGB","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Talarmin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02pcvrc50","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, Centre Hospitalier de Cornouaille","place":["Quimper, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudie","family":"Lamoureux","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Agents, CHU Brest","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"P\u00e9r\u00e8s","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, CHU Brest","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Le Bars","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Agents, CHU Brest","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0064-9438","authenticated-orcid":true,"given":"Marie-Sarah","family":"Fangous","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02pcvrc50","id-type":"ROR","asserted-by":"publisher"}],"name":"Laboratory of Microbiology, Centre Hospitalier de Cornouaille","place":["Quimper, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6163-2947","authenticated-orcid":true,"given":"Cl\u00e9mence","family":"Beauruelle","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Agents, CHU Brest","place":["Brest, France"]},{"name":"Univ Brest, Inserm, EFS, UMR 1078, GGB","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9verine","family":"Ansart","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, CHU Brest","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2089-3825","authenticated-orcid":true,"given":"Genevi\u00e8ve","family":"H\u00e9ry-Arnaud","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Agents, CHU Brest","place":["Brest, France"]},{"name":"Univ Brest, Inserm, EFS, UMR 1078, GGB","place":["Brest, France"]},{"id":[{"id":"https:\/\/ror.org\/03evbwn87","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Biome Analysis and Microbiota (CBAM), CHU Brest","place":["Brest, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/jips.jips_183_17"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2334\/josnusd.19-0021"},{"key":"e_1_3_2_4_2","unstructured":"Diseases M Douglas and Bennett\u2019s Principles and Practice of Infectious. 2024. 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