Abstract
Gemella haemolysans a is facultatively anaerobic gram-positive cocci isolated from the blood cul-tures of patients with endocarditis. Serious cardiovascular adverse events have been reported following novel coronavirus (COVID-19) vaccination. We report a novel case of G. haemolysans endocarditis following the first dose of the ChAdOx1-S (recombinant) COVID-19 vaccine. A 41-year-old Saudi male with a documented history of congenital valvular heart defects presented to our hospital facility with a sore throat, dry cough, documented high-grade fever of more than 39 & DEG;C on different occasions and fatigue for two weeks. There was no history of COVID infection in the past or contact with a patient with diagnosed COVID-19 infection. The patient received the first dose of the recombinant ChAdOx1-S COVID-19 vaccine 3 days before the onset of symptoms. A pansystolic murmur diffuse was noted on cardiovascular examination. Laboratory examinations revealed an elevated ESR of 60 mm/h, elevated LDH, raised complement C4 and ferritin concentrations and low levels of monocytes and serum calcium. Transoesophageal echocardiogram demonstrated severe subvalvular pulmonary stenosis with multiple vegetations. The culture and sensitivity test of aerobic blood cultures showed gram-positive cocci of Gemella haemolysans. The patient was diagnosed with pulmonary valve in-fective endocarditis and prolonged antibiotic treatment was initiated. He made a full recovery on antibiotic treatment and subsequently underwent pulmonary valve repair/replacement surgery. Based on this report and the reviewed literature, Gemella haemolysans endocarditis should be suspected in patients with valvular heart disease receiving COVID-19 vaccination and managed appropriately to avoid its severe manifestations and mortality. Clinicians should suspect such infections in case of suggestive symptoms during postvaccina-tion surveillance, and encourage the patients to seek early medical attention.