{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:35:03Z","timestamp":1772724903637,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,18]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    <jats:italic>Staphylococcus lugdunensis<\/jats:italic>\n                    is a highly virulent coagulase-negative staphylococcus, capable of causing rapidly destructive infective endocarditis (IE). We report an elderly male who developed P wave asystole as the initial manifestation of\n                    <jats:italic>S. lugdunensis<\/jats:italic>\n                    IE, occurring in the absence of fever or classical IE symptoms. Transoesophageal echocardiography (TOE) revealed severe aortic regurgitation from cusp destruction, a perivalvular abscess and an acquired Gerbode defect\u2014a rare left ventricular-to-right atrial communication. An urgent aortic valve replacement was performed, and intraoperatively, the Gerbode defect was found to have spontaneously closed. Due to permanent pacing requirements and infection risk, a leadless pacemaker was implanted. This case underscores the importance of suspecting IE in unexplained conduction abnormalities, recognising the virulence of\n                    <jats:italic>S. lugdunensis<\/jats:italic>\n                    and using early TOE to detect life-threatening structural complications.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-269446","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:35:15Z","timestamp":1772721315000},"page":"e269446","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Staphylococcus lugdunensis<\/i>\n                    endocarditis presenting with P wave asystole, valvular destruction and spontaneous closure of an acquired Gerbode defect"],"prefix":"10.1136","volume":"19","author":[{"given":"Patrick","family":"Tran","sequence":"first","affiliation":[{"name":"Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Anwar","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kuehl","sequence":"additional","affiliation":[{"name":"Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prithwish","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"2026030506350565000_19.3.e269446.1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/jcecho.jcecho_77_24","article-title":"Complex Infective Endocarditis: Uncommon Presentations and Their Multisystem Complications - A Case Series","volume":"35","author":"Cacciapuoti","year":"2025","journal-title":"J Cardiovasc Echogr"},{"key":"2026030506350565000_19.3.e269446.2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.4103\/jpgm.JPGM_13_19","article-title":"Gerbode defect: A rare complication of infective endocarditis","volume":"65","author":"Mert","year":"2019","journal-title":"J Postgrad Med"},{"key":"2026030506350565000_19.3.e269446.3","doi-asserted-by":"crossref","DOI":"10.1111\/anec.12849","article-title":"PR interval prolongation is significantly associated with aortic root abscess: An age- and gender-matched study","volume":"26","author":"Kohli","year":"2021","journal-title":"Ann Noninvasive Electrocardiol"},{"key":"2026030506350565000_19.3.e269446.4","article-title":"Infective Endocarditis Due to Streptococcus agalactiae Complicated by a Complete Atrioventricular Block","volume":"15","author":"Miyagishima","year":"2023","journal-title":"Cureus"},{"key":"2026030506350565000_19.3.e269446.5","first-page":"292","article-title":"Gerbode Defect as a Result of Fungal Aortic Valve Endocarditis","volume":"24","author":"Pasrija","year":"2015","journal-title":"J Heart Valve Dis"},{"key":"2026030506350565000_19.3.e269446.6","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jsha.2017.01.006","article-title":"Gerbode defect: A comprehensive review of its history, anatomy, embryology, pathophysiology, diagnosis, and treatment","volume":"29","author":"Saker","year":"2017","journal-title":"J Saudi Heart Assoc"},{"key":"2026030506350565000_19.3.e269446.7","article-title":"When Two Chambers Collide: A Rare Case of an Acquired Gerbode Defect in Infective Endocarditis","volume":"12","author":"Rimsky","year":"2025","journal-title":"Eur J Case Rep Intern Med"},{"key":"2026030506350565000_19.3.e269446.8","doi-asserted-by":"crossref","DOI":"10.1186\/s13019-015-0320-z","article-title":"Acquired Gerbode defect following endocarditis of the tricuspid valve: a case report and literature review","volume":"10","author":"Prifti","year":"2015","journal-title":"J Cardiothorac Surg"},{"key":"2026030506350565000_19.3.e269446.9","doi-asserted-by":"crossref","DOI":"10.1186\/1476-7120-8-44","article-title":"Gerbode defect following endocarditis and misinterpreted as severe pulmonary arterial hypertension","volume":"8","author":"Xhabija","year":"2010","journal-title":"Cardiovasc Ultrasound"},{"key":"2026030506350565000_19.3.e269446.10","article-title":"Acquired Gerbode Defect in a Patient With Infective Endocarditis of Bicuspid Aortic Valve","volume":"13","author":"Mahdi","year":"2021","journal-title":"Cureus"},{"key":"2026030506350565000_19.3.e269446.11","doi-asserted-by":"crossref","DOI":"10.1093\/ehjci\/jet192","article-title":"A spontaneously closed, acquired supravalvular Gerbode defect mimicking an unruptured sinus of Valsalva aneurysm","volume":"15","author":"Hsu","year":"2014","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026030506350565000_19.3.e269446.12","doi-asserted-by":"crossref","DOI":"10.1128\/spectrum.02749-24","article-title":"Clinical presentation, treatment, and antimicrobial susceptibility of 155 sequential","volume":"13","author":"Palumbo","year":"2025","journal-title":"Microbiol Spectr"},{"key":"2026030506350565000_19.3.e269446.13","article-title":"The Deadly Contaminant: A Case of Staphylococcus lugdunensis Endocarditis","volume":"15","author":"Ibrahim","year":"2023","journal-title":"Cureus"},{"key":"2026030506350565000_19.3.e269446.14","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-006-0169-0"},{"key":"2026030506350565000_19.3.e269446.15","doi-asserted-by":"crossref","unstructured":"Singhal P , Kanjanauthai S , Kwan W . Recurrent Multivalvular. Case Rep Cardiol 2021;5334088. doi:10.1155\/2021\/5334088","DOI":"10.1155\/2021\/5334088"},{"key":"2026030506350565000_19.3.e269446.16","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad625"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:35:18Z","timestamp":1772721318000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,5]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-269446"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269446","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}