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February 1989

Clostridial Endocarditis: Report of a Case Caused by Clostridium bifermentans and Review of the Literature

Author Affiliations

From the Divisions of General Internal Medicine (Drs Kolander and Cosgrove) and Infectious Disease (Dr Molavi), Hahnemann University Hospital, Philadelphia.

Arch Intern Med. 1989;149(2):455-456. doi:10.1001/archinte.1989.00390020143032

• A case of Clostridium bifermentans endocarditis occurred in a 23-year-old man who was an intravenous drug user. There was no history of preexisting valvular heart disease. He was initially treated with high-dose penicillin G potassium but remained bacteremic for a ten-day period. The bacteremia resolved when the therapy was changed to metronidazole hydrochloride. A review of the 16 reported cases of clostridial endocarditis showed no predisposing host factor to the development of the disease. Penicillin is the treatment of choice for clostridial endocarditis, but metronidazole should be considered as an alternate therapy for treatment that fails.

(Arch Intern Med 1989;149:455-456)

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