NEISSERIA SICCA ENDOCARDITIS PRESENTING W ITH MULTIPLE ORGAN FAILURE

The authors report a case of Neisseria sicca endocarditis presenting w ith multiple organ failure in a 33 year old intravenous drug user. The diagnosis was confirmed by transthoracic and transoesophageal echocar diography showing Vegetations on the aortic valve and three blood cult ures positive for Neisseria Sicca. Massive aortic regurgitation occurr ed on the 4th day. The patient died of complications of intracerebral haematomas before surgical intervention. Contrary to pathogenic Neisse iria gonorrhoeae and meningitides, saprophytic Neisseria, including Ne isseria sicca, are commensal organisms of the upper respiratory tract. They are exceptionally rare causes of endocarditis. A review of the l iterature from the era of antibiotic therapy, found about thirty cases of saprophytic Neisseria endocarditis of which only five were due to Neisseria sicca. The clinical characteristics were the young age, the mainly left heart valve disease and the high incidence of cerebrovascu lar accidents. The originality of this case was the exceptionaly rare involvement of this organism and the multiplicity of the extracardiac manifestations, especially renal and neurological.