Mycoplasma hominis is a habitual colonizing microorganism of the lower genital tract but can exceptionally be the causal agent of blood culture-negative infective endocarditis (IE). Only 11 cases of this entity have been published to date. The study objectives were to describe the first case diagnosed in our center of IE by M. hominis on pacemaker lead and to carry out a narrative review. Among published cases of IE by this microorganism, 72.7% were male, with a mean age of 45 years and a history of valve surgery; the diagnosis was by culture (54.5%) or molecular technique (45.5%), and the prognosis was favorable in 72.7% of cases. The most frequently prescribed antibiotics were doxycycline, quinolones, and clindamycin.

Brief Papers; Authors: A. Bustos-Merlo, A. Ortiz-Parra, A. Rosales-Castillo, J.M. Espinosa-Sanchez, N. Navarrete-Navarrete

Corynebacterium jeikeium, a pleomorphic Gram-positive bacillus, is a common component of the cutaneous microbiota, usually considered as a contaminant, with little pathogenic potential. However, its role in various types of infections, such as bacteremia, sepsis, endocarditis (IE) and infection of prosthetic material is gradually being proven. Few cases of IE due to Corynebacterium jeikeium have been described in the literature. The aim of this article was to describe four cases of IE due to Corynebacterium jeikeium diagnosed in our hospital between May 2021 and April 2022, as well as to conduct a narrative review of the literature on this entity. After analysis, we highlight that 65.6% were men, 81.3% were valve or intravascular device carriers, and IE cases presented early, before one year after surgery. The most affected valve was the aortic valve (68.8%), followed by the mitral valve (21.1%). Valve replacement was performed in 65.6% of cases, and the most commonly used antibiotic was vancomycin (68.8%) at a dose of 15 mg/kg/12 h. With respect to prognosis, the overall mortality rate was 21.9%. The comparative results between our series and the literature review were similar except for a higher mortality rate (50%) and the use of dalbavancin in the treatment. We go on to review previously reported cases, along with four cases described in our hospital, of C. jeikeium endocarditis and will discuss various aspects of C. jeikeium infection, focusing on microbiology, pathophysiology, and treatment.

Background: Renal denervation (RDN) is an emerging therapy for selected patients with resistant hypertension. Its broader autonomic effects may extend beyond blood pressure regulation. Case summary: A 57-year-old man with resistant hypertension treated with six antihypertensive drugs and recurrent autonomic and generalized seizures underwent radiofrequency RDN. At 3 months, ambulatory blood pressure monitoring showed sustained improvement (24 h mean 139/87 mmHg), enabling therapy de-escalation. Generalized tonic–clonic seizures resolved, and autonomic/focal events markedly decreased without changes in antiepileptic medication. Discussion: This case illustrates a potential extrapressor effect of RDN mediated by modulation of sympathetic overactivity. Although causality cannot be drawn from a single case, the parallel neurological improvement supports exploring RDN’s role in conditions involving autonomic dysregulation, including certain epileptic syndromes.

The number of patients suffering from refractory hypertension and advanced-stage chronic heart failure (CHF) is progressively increasing. In recent years, device-mediated therapies have been developed as an alternative or adjunct to conventional medical treatment. Our primary objective is to describe the clinical experience in a series of patients with refractory hypertension following the implantation of baroreceptor activation therapy (BAT). We analyzed 5 patients with refractory hypertension, one of whom also had CHF, treated in a specialized cardiovascular risk clinic. After the implantation of the Barostim device with an average activation of 3.64mA (ranging from 2.80 to 5.4), there was a mean reduction of 30±7.68mmHg (P=0.001) and 13.40±9.07mmHg (P=0.03) in systolic and diastolic blood pressure, respectively, as measured by ambulatory blood pressure monitoring (ABPM), along with a heart rate reduction of 25±9.13 bpm (P=0.004). A reduction in the number of antihypertensive medications required for blood pressure control was observed, with an average of 5.2 medications, as well as an improvement in functional class. No adverse events were recorded in our patient series. Currently, BAT is considered a compassionate-use alternative for blood pressure control in patients with refractory hypertension and failure of pharmacological treatment and other invasive techniques, such as renal denervation.

Multiple diagnostic entities are included among the causes of secondary arterial hypertension, so an appropriate screening is essential to diagnose potentially treatable pathologies. Genetic syndromes occupy a small percentage of these causes. The latter group includes Liddle syndrome, a rare genetic disease with autosomal dominant inheritance, caused by gain-of-function mutations in the genes that code for the epithelial sodium channel (ENaC), involved in sodium reabsorption in the distal renal tubules. The presence of a family history of arterial hypertension with onset at an early age and hypokalemia in some of them should lead to the suspicion of this genetic disorder, which must be confirmed with genetic tests. We describe a case, genetically confirmed, in which hypertension refractory to conventional treatment is the only manifestation of said syndrome, making diagnosis difficult and delayed until adulthood.