Successful Oral Ciprofloxacin Therapy of Neisseria elongata Endocarditis

Objective: To report successful oral ciprofloxacin therapy for Neisseria elongata endocarditis. Case Summary: A patient with N elongata endocarditis refused parenteral therapy, but his infection completely resolved with 7 weeks of oral ciprofloxacin. Discussion: This patient’s refusal of parenteral therapy prompted the use of oral ciprofloxacin because it is well absorbed and was expected to be very active against his organism. His infection resolved and did not relapse. Although successful oral therapy has been reported for endocarditis caused by Staphylococcus aureus, primarily in injection drug users, completely oral therapy for other organisms has not been previously described. Conclusions: When parenteral therapy is not possible, oral administration of highly active, well-absorbed antibiotics may be effective for selected cases of endocarditis caused by susceptible organisms.