No. 42 (2021) , Original Article
No. 42 (2021) | Original Article | Published 2021-05-12

Infectious Endocarditis in Dogs with a Previous Diagnosis of Peripheral Vestibular Syndrome Secondary to Probable Otitis Media-Interna: A Case Report

María Andrea Guzmán Solano
Universidad Nacional Autónoma de México
Pedro Vargas-Pinto
Universidad de La Salle, Bogotá
César Augusto Cabrejo Saavedra
Universidad de La Salle, Bogotá

Abstract

Infectious endocarditis is a pathological process with low incidence in the daily clinical practice. The main etiology are the bacterial agents that colonize with higher prevalence the mitral and aortic valves. This paper reports the case of a dog with a previous diagnosis of peripheral vestibular syndrome secondary to probable otitis media-interna. The dog has a sudden heart murmur, intermittent claudications, lack of appetite, depression and temperatures. It is performed an echocardiographic assessment that shows mitral valve thickening with hyperecoic structures in the free border that indicates vegetations. Using the Modified Duke Criteria, a definitive diagnosis of infectious endocarditis is concluded. The dog is provided a medical treatment at the clinic without success. The clinical and paraclinical findings match the background found in the literature. Modified Duke Criteria allow guiding the diagnosis process and uncovering the alarm clinical signs. Antimicrobial clinical treatment must be administered based on blood cultures and sensitivity tests and considering both the pathogen prevalence and infection primary origin. Doctors must deem this condition as a bad prognosis pathology with a high mortality percentage. Finally, it is concluded that the main limitation in this case is a lack of histopathological confirmation.
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References

MacDonald, K. Infective endocarditis in dogs: diagnosis and therapy. Vet Clin North Am Small Anim Pract. 2010;40(4):665-84. https://doi.org/10.1016/j.cvsm.2010.03.010

Nakamura, R. Zimmerman SA, Lange AJ, Lesser MB. Isolation of methicillin-resistant Staphylococcus lugdunensis in a dog with endocarditis. J Vet Cardiol. 2012;14(4):531-6. https://doi.org/10.1016/j.jvc.2012.04.002

Kern, Z. Swartley OM, Neupane P, Balakrishnan N, Breitschwerdt EB. Pasteurella canis infective endocarditis in a dog. Vet Microbiol. 2019;229:14-9. https://doi.org/10.1016/j.vetmic.2018.12.001

Balakrishnan N, Alexander K, Keene B, Kolluru S, Fauls ML, Rawdon I, Breitschwerdt EB. Successful treatment of mitral valve endocarditis in a dog associated with ‘Actinomyces canis-like’ infection. J Vet Cardiol. 2016;18(3):271-7. https://doi.org/10.1016/j.jvc.2016.04.005

Peddle G, Sleeper M. Canine bacterial endocarditis: A review J Am Anim Hosp Assoc. 2007;43(5):258-63. https://doi.org/10.5326/0430258

Miller M, Fox PR, Saunders AB. Pathologic and clinical features of infectious endocarditis. J Vet Cardiol. 2004;6(2):35-43. https://doi.org/10.1016/S1760-2734(06)70056-X

Ohad. D, Morick D, Avidor B, Harrus S. Molecular detection of Bartonella henselae and Bartonella koehlerae from aortic valves of Boxer dogs with infective endocarditis. Vet Microbiol. 2010;141(1-2):182-5. https://doi.org/10.1016/j.vetmic.2009.08.005

Palerme JS, Jones AE, Ward JL, Balakrishnan N, Linder KE, Breitschwerdt EB, Keene BW. Infective endocarditis in 13 cats. J Vet Cardiol. 2016;18(3):213-25. https://doi.org/10.1016/j.jvc.2016.04.003

Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Prevention of infective endocarditis: guidelines from the American Heart Association. 2007;116(15):1736-54. https://doi.org/10.1161/CIRCULATIONAHA.106.183095

Sykes JE, Kittleson MD, Pesavento PA, Byrne BA, MacDonald KA, Chomel BB. Evaluation of the relationship between causative organisms and clinical characteristics of infective endocarditis in dogs: 71 cases (1992-2005). J Am Vet Med Assoc. 2006;228(11):1723-34. https://doi.org/10.2460/javma.228.11.1723

Roura, X. Santamarina G, Tabar MD, Francino O, Altet L. Polymerase chain reaction detection of Bartonella spp. in dogs from Spain with blood culture-negative infectious endocarditis. J Vet Cardiol. 2018 Aug;20(4):267-275. https://doi.org/10.1016/j.jvc.2018.04.006

Brown, V. Aortic valvular endocarditis in a dog. Can Vet J. 2004;45(8):682-4

Chomel, BB, Kasten RW, Williams C, Wey AC, Henn JB, Maggi R, Carrasco S, Mazet J, Boulouis HJ, Maillard R, Breitschwerdt EB. Bartonella endocarditis: a pathology shared by animal reservoirsand patients. Ann N Y Acad Sci. 2009;1166:120-6. https://doi.org/10.1111/j.1749-6632.2009.04523.x

Pesavento PA, Chomel BB, Kasten RW, McDonald KA, Mohr FC. Pathology of bartonella endocarditis in six dogs. Vet Pathol. 2005;42(3):370-3. https://doi.org/10.1354/vp.42-3-370

A Yang C, Daneman N, Hansen MS, Habib G, Salaun E, Lavoute C, Hubert S, Adhikari NKJ. Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis. Clin Microbiol Infect. 2019 Feb;25(2):178-187. https://doi.org/10.1016/j.cmi.2018.08.010

Li, JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, Bashore T, Corey GR. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000 Apr;30(4):633-8. https://doi.org/10.1086/313753

Topan A, Carstina D, Slavcovici A, Rancea R, Capalneanu R, Lupse M. Assesment of the Duke criteria for the diagnosis of infective endocarditis after twenty-years. An analysis of 241 cases. Clujul Med. 2015;88(3):321-6. https://doi.org/10.15386/cjmed-469

Chetboul, V, Tessier D, Rosenberg D, Boussouf M, Escoffier L, Lugardon B, Pouchelon JL. Echocardiographic findings in a dog with vegetative bacterial endocarditis (Case report). J Vet Cardiol. 1999;1(1):27-31. https://doi.org/10.1016/S1760-2734(06)70027-3

Clark GK, Spier A, Nestor D, Rizzo S. Bacterial Endocarditis of the Pulmonic Valve in a Dog. J Am Anim Hosp Assoc. 2018;54(5):e54502. https://doi.org/10.5326/JAAHA-MS-6582

Sykes JE, Kittleson MD, Chomel BB, Macdonald KA, Pesavento PA. Clinicopathologic findings and outcome in dogs with infective endocarditis: 71 cases (1992-2005). J Am Vet Med Assoc. 2006 Jun 1;228(11):1735-47. https://doi.org/10.2460/javma.228.11.1735

Chomel BB, Mac Donald KA, Kasten RW, Chang CC, Wey AC, Foley JE, Thomas WP, Kittleson MD. Aortic valve endocarditis in a dog due to Bartonella clarridgeiae. J Clin Microbiol. 2001;39(10):3548-54. https://doi.org/10.1128/JCM.39.10.3548-3554.2001

Chetboul V. Advanced techniques in echocardiography in small animals. Vet Clin North Am Small Anim Pract. 2010;40(4):529-43. https://doi.org/10.1016/j.cvsm.2010.03.007

Okaro U, Addisu A, Casanas B, Anderson B. Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis. Clin Microbiol Rev. 2017;30(3):709-46. https://doi.org/10.1128/CMR.00013-17

Biswas S, Maggi RG, Papich MG, Breitschwerdt EB. Molecular mechanisms of Bartonella henselae resistance to azithromycin, pradofloxacin and enrofloxacin. J Antimicrob Chemother. 2010 Mar;65(3):581-2. https://doi.org/10.1093/jac/dkp459

Rolain JM, Maurin M, Raoult D. Bactericidal effect of antibiotics on Bartonella and Brucella spp.: clinical implications. J Antimicrob Chemother. 2000;46(5):811-4. https://doi.org/10.1093/jac/46.5.811

Kittleson M, Kienle R. Medicina cardiovascular de pequeños animales. México: Multimédica; 2000. 612 p.

Peddle GD, Drobatz KJ, Harvey CE, Adams A, Sleeper MM. Association of periodontal disease, oral procedures, and other clinical findings with bacterial endocarditis in dogs. J Am Vet Med Assoc. 2009;234(1):100-7. https://doi.org/10.2460/javma.234.1.100

Hackett TB. Introduction to multiple organ dysfunction and failure. Vet Clin North Am Small Anim Pract. 2011;41(4):703-7, v. https://doi.org/10.1016/j.cvsm.2011.05.003

Bulmer BJ. Cardiovascular dysfunction in sepsis and critical illness. Vet Clin North Am Small Anim Pract. 2011;41(4):717-26, v. https://doi.org/10.1016/j.cvsm.2011.04.003

Salgado D, Rodriguez C. Bacteriemia, sepsis y shock séptico. Tratado de geriatria para residentes; 2005. p. 409-416

Keywords

infectious endocarditis
valve insufficiency
Modified Duke Criteria
sudden heart murmur
vegetations