Granulicatella adiacens Infective Endocarditis Treated With Teicoplanin and Ceftriaxone: A Case Report

We describe a case of infective endocarditis (IE) caused by Granulicatella adiacens in a patient who had fever for 4 months before admission. He had a complex medical history of active hyperthyroidism and schizophrenia, which might have misled the clinician in ignoring the existence of a serious infection like IE. A history of splenectomy and the likelihood of congenital cardiac valve deficiency were the possible underlying risk factors. His persistent leukocytosis perplexed our judgement in terms of resolution of infection and treatment efficacy, which was probably due to his splenectomy. C-reactive protein was the alternative laboratory indicator. Clinical and Laboratory Standards Institute criteria have not been established for the fastidious G. adiacens. Therefore, we referred to the viridans group streptococci and literature to evaluate antimicrobial susceptibility testing. We suggest that teicoplanin combined with ceftriaxone could serve as an effective therapy for IE caused by G. adiacens.