{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:02:50Z","timestamp":1760148170662,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Congenital heart disease (CHD) remains a predisposing cardiac condition for infective endocarditis (IE). Case report: We present the case of 8-year-old boy with no known pre-existing cardiac disease diagnosed with infective endocarditis (IE) with Gemella sanguinis. After admission, he underwent transthoracic echocardiography (TTE), which revealed the presence of Shone syndrome with a bicuspid valve, mitral parachute valve and severe aortic coarctation. He developed a paravalvular aortic abscess with severe aortic regurgitation and left ventricle (LV) systolic dysfunction for which he required a complex surgical intervention after six weeks of antibiotic treatment, consisting of Ross operation and coarctectomy, with a complicated postoperative course, cardiac arrest and ECMO support for five days. The evolution was slow and favorable, with no significant residual valvular lesions. However, persistent LV systolic dysfunction and increased muscle enzymes required further investigation to establish a genetic diagnosis of Duchenne disease. As Gemella is not considered a frequent pathogen of IE, no current guidelines refer specifically to it. Additionally, the predisposing cardiac condition of our patient is not currently classified as \u201chigh-risk\u201d for IE; this is not considered an indication for IE prophylaxis in the current guidelines. Conclusion: This case illustrates the importance of accurate bacteriological diagnosis in infective endocarditis and poses concerns regarding the necessity of IE prophylaxis in \u201cmoderate risk\u201d cardiac conditions such as congenital valvular heart disease, especially aortic valve malformations.<\/jats:p>","DOI":"10.3390\/antibiotics12040706","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T02:11:41Z","timestamp":1680660701000},"page":"706","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Gemella sanguinis Infective Endocarditis\u2014Challenging Management of an 8-Year-Old with Duchenne Dystrophy and Undiagnosed Congenital Heart Disease: A Case Report"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3824-1489","authenticated-orcid":false,"given":"Cristina","family":"Filip","sequence":"first","affiliation":[{"name":"Department of Pediatrics, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Pediatric Cardiology, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4684-8213","authenticated-orcid":false,"given":"Corina Maria","family":"Vasile","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"},{"name":"Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6028-2407","authenticated-orcid":false,"given":"Georgiana","family":"Nicolae","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Margarint","sequence":"additional","affiliation":[{"name":"Ph.D. School Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Pediatric Cardiovascular Surgery, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loredana","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Bizubac","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Neonatal Intensive Care Unit, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Ganea","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"},{"name":"Ph.D. School Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"},{"name":"Ph.D. School Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Murzi","sequence":"additional","affiliation":[{"name":"Fondazione Toscana \u201cGabriele Monasterio\u201d, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-0330","authenticated-orcid":false,"given":"Mihaela","family":"Balgradean","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Pediatric Nephrology, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7778-0477","authenticated-orcid":false,"given":"Catalin","family":"Cirstoveanu","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Neonatal Intensive Care Unit, \u201cM.S. Curie\u201d Children\u2019s Clinical Hospital, 041451 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1136\/hrt.2003.029868","article-title":"Echocardiography in infective endocarditis","volume":"90","author":"Evangelista","year":"2004","journal-title":"Heart"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1086\/313753","article-title":"Proposed Modifications to the Duke Criteria for the Diagnosis of Infective Endocarditis","volume":"30","author":"Li","year":"2000","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1067\/mje.2003.36","article-title":"Mechanical prosthetic valve-associated strands: Pathologic correlates to transesophageal echocardiography","volume":"16","author":"Rozich","year":"2003","journal-title":"J. Am. 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