{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T12:15:33Z","timestamp":1767183333277},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":678,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Avicenna J Med"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Infective endocarditis (IE) remains a prevalent disease with a high rate of morbidity and mortality. Recent changes have been noted in the profile of causative microorganisms. In this report, we describe a case of Gemella-related endocarditis and review the related literature. Our patient was an 81-year-old man who presented with dyspnea and fatigue. His initial examination revealed a new systolic murmur. Echocardiogram revealed moderate mitral regurgitation with 1-cm mass on the anterior mitral leaflet, and blood cultures grew Gemella haemolysans. Penicillin and gentamicin were initiated, and workup for possible source was positive for a colonic polyp with high-grade dysplasia. The patient subsequently developed cardiogenic shock and severe pulmonary edema. Comfort care measures were initiated, and he passed away thereafter. We reviewed PubMed for cases of Gemella-related endocarditis. We found 65 documented cases and added our patient\u2019s case to the analysis. Seventy-two percent of the cases occurred in men. The mean age was 51 years and 42% of the patients were older than 60 years. Fever was the most common presenting symptom and most of the cases presented subacutely. The mitral valve was the most affected site and 50% of the patients required surgical intervention. G. morbillorum was the most common subtype and a total of four cases were found to be associated with colorectal neoplasm. As a conclusion, Gemella species rarely cause IE. The absence of a clear source of bacteremia warrants further evaluation for a gastrointestinal source. The infection can be destructive and must be promptly treated to avoid complications.<\/jats:p><jats:p>morbillorum Key messages: Gemella endocarditis is a serious infection with significant morbidity and mortality. It must be promptly treated to avoid further complications.<\/jats:p>","DOI":"10.4103\/ajm.ajm_3_19","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T07:15:48Z","timestamp":1560410148000},"page":"164-168","source":"Crossref","is-referenced-by-count":22,"title":["Gemella endocarditis: A case report and a review of the literature"],"prefix":"10.1055","volume":"09","author":[{"given":"Dima","family":"Youssef","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Ascension Saint John Hospital and Medical Center, Detroit, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Youssef","sequence":"additional","affiliation":[{"name":"Michigan Medicine, University of Michigan, Ann Arbor, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tariq S","family":"Marroush","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ascension Saint John Hospital and Medical Center, Detroit, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamta","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Ascension Saint John Hospital and Medical Center, Detroit, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,8,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1016\/j.jacc.2015.03.518","article-title":"Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011","volume":"65","author":"S Pant","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"e67519","DOI":"10.1371\/journal.pone.0067519","article-title":"A nationwide cohort study of mortality risk and long-term prognosis in infective endocarditis in Sweden","volume":"8","author":"A Ternhag","year":"2013","journal-title":"PLoS One"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.gheart.2014.01.002","article-title":"Global and regional burden of infective endocarditis, 1990-2010: A systematic review of the literature","volume":"9","author":"S Sinha","year":"2014","journal-title":"Glob Heart"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1056\/NEJMra010082","article-title":"Infective endocarditis in adults","volume":"345","author":"E Mylonakis","year":"2001","journal-title":"N Engl J Med"},{"key":"ref6","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":"J S Li","year":"2000","journal-title":"Clin Infect Dis"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.idc.2009.04.013","article-title":"Acute infective endocarditis","volume":"23","author":"J R McDonald","year":"2009","journal-title":"Infect Dis Clin North Am"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1086\/339045","article-title":"Infective endocarditis in elderly patients","volume":"34","author":"V K Dhawan","year":"2002","journal-title":"Clin Infect Dis"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1007\/s10096-016-2660-6","article-title":"The causative agents in infective endocarditis: A systematic review comprising 33,214 cases","volume":"35","author":"C T Vogkou","year":"2016","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"3012","DOI":"10.1001\/jama.293.24.3012","article-title":"ICE Investigators Staphylococcus aureus endocarditis: A consequence of medical progress","volume":"293","author":"VG Jr Fowler","year":"2005","journal-title":"JAMA"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1128\/CMR.14.1.177-207.2001","article-title":"Endocarditis due to rare and fastidious bacteria","volume":"14","author":"P Brouqui","year":"2001","journal-title":"Clin Microbiol Rev"},{"key":"ref12","first-page":"191","article-title":"Emerging issues in infective endocarditis","volume":"15","author":"B C Millar","year":"2004","journal-title":"Rev Biomed"},{"key":"ref13","first-page":"317","article-title":"Gemella species endocarditis in a child","volume":"12","author":"L K Purcell","year":"2001","journal-title":"Can J Infect Dis"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1253\/jcj.62.626","article-title":"Prosthetic ball valve endocarditis due to Gemella species","volume":"62","author":"A Ukimura","year":"1998","journal-title":"Jpn Circ J"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"4897","DOI":"10.1128\/JCM.42.10.4897-4900.2004","article-title":"Gemella bergeriae endocarditis diagnosed by sequencing of rRNA genes in heart valve tissue","volume":"42","author":"S Elsayed","year":"2004","journal-title":"J Clin Microbiol"},{"key":"ref16","first-page":"442","article-title":"Transfer of Streptococcus morbillorum to the genus Gemella as Gemella morbillorum comb. nov","volume":"38","author":"R Kilpper-B\u00e4lz","year":"1988","journal-title":"Int J Syst Evol Microbiol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1128\/CMR.8.4.479","article-title":"Identification, classification, and clinical relevance of catalase-negative, gram-positive cocci, excluding the streptococci and enterococci","volume":"8","author":"R Facklam","year":"1995","journal-title":"Clin Microbiol Rev"},{"key":"ref18","first-page":"527","article-title":"Neisseria hemolysans. A hemolytie species of Neisseria trevisan","volume":"15","author":"T Thj\u00f6tta","year":"1938","journal-title":"Acta Pathol Microbiol Scand"},{"key":"ref19","first-page":"1028","article-title":"The cultivation of a micrococcus from blood in pre-eruptive and eruptive stages of measles","volume":"68","author":"R Tunnicliff","year":"1971","journal-title":"J Am Med Assoc"},{"key":"ref20","first-page":"17","article-title":"A proposed new genus of gram-negative cocci: Gemella","volume":"11","author":"U Berger","year":"1961","journal-title":"Int J Syst Evol Microbiol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1093\/clinids\/22.6.1084","article-title":"Gemella morbillorum as a cause of septic shock","volume":"22","author":"S Vasishtha","year":"1996","journal-title":"Clin Infect Dis"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"e82665","DOI":"10.1371\/journal.pone.0082665","article-title":"Infective endocarditis epidemiology over five decades: A systematic review","volume":"8","author":"L Slipczuk","year":"2013","journal-title":"PLoS One"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"442","DOI":"10.3389\/fcimb.2018.00442","article-title":"The oral microbiome in the elderly with dental caries and health","volume":"8","author":"Q Jiang","year":"2018","journal-title":"Front Cell Infect Microbiol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"204","DOI":"10.4251\/wjgo.v7.i10.204","article-title":"Treatment of colorectal cancer in the elderly","volume":"7","author":"M Millan","year":"2015","journal-title":"World J Gastrointest Oncol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1093\/ofid\/ofv133.1287","article-title":"In vitro susceptibility of Gemella species from clinical isolates","volume":"2","author":"J Baghdadi","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/BF02014200","article-title":"Antimicrobial susceptibility of Gemella haemolysans isolated from patients with subacute endocarditis","volume":"1","author":"A Buu-Ho\u00ef","year":"1982","journal-title":"Eur J Clin Microbiol"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1046\/j.0902-0055.2001.00098.x","article-title":"Bacteriology and antimicrobial susceptibility of gram-positive cocci isolated from pus specimens of orofacial odontogenic infections","volume":"17","author":"T Kuriyama","year":"2002","journal-title":"Oral Microbiol Immunol"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1161\/CIR.0000000000000296","article-title":"Infective endocarditis in adults: Diagnosis, antimicrobial therapy, and management of complications: A scientific statement for healthcare professionals from the American Heart Association","volume":"132","author":"L M Baddour","year":"2015","journal-title":"Circulation"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/clinids\/22.2.379","article-title":"Association of Gemella morbillorum endocarditis with adenomatous polyps and carcinoma of the colon: Case report and review","volume":"22","author":"M Lopez-Dupla","year":"1996","journal-title":"Clin Infect Dis"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"e39743","DOI":"10.1371\/journal.pone.0039743","article-title":"Human intestinal lumen and mucosa-associated microbiota in patients with colorectal cancer","volume":"7","author":"W Chen","year":"2012","journal-title":"PLoS One"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"e00102","DOI":"10.1128\/mSphere.00102-16","article-title":"Metabolic and community synergy of oral bacteria in colorectal cancer","volume":"1","author":"K J Flynn","year":"2016","journal-title":"mSphere"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/01.idc.0000269918.02725.b4","article-title":"Infective endocarditis caused by Gemella species","volume":"15","author":"J S Stroup","year":"2007","journal-title":"Infect Dis Clin Pract"}],"container-title":["Avicenna Journal of Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.4103\/AJM.AJM_3_19.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T22:36:25Z","timestamp":1628548585000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.4103\/AJM.AJM_3_19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":31,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2021,8,9]]},"published-print":{"date-parts":[[2019,10]]}},"URL":"https:\/\/doi.org\/10.4103\/ajm.ajm_3_19","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2231-0770","2249-4464"],"issn-type":[{"value":"2231-0770","type":"print"},{"value":"2249-4464","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}