1887

Abstract

Introduction:

, a Gram-variable, rod-shaped organism, was previously thought to be non-pathogenic. However, in recent years it has become increasingly recognized as a rare cause of infective endocarditis. Here, to the best of our knowledge, we describe the first case of bivalvular prosthetic valve endocarditis due to .

Case Presentation:

A 55-year-old Taiwanese man with history of endocarditis status post prosthetic mitral and aortic valve replacements presented with a 2-week history of progressive fatigue and altered mental status. He presented with fever, lethargy and shock. He was intubated and started on vasopressors. A systolic murmur was noted with leukocytosis and acute renal failure. He was started on broad-spectrum antibiotics. An initial trans-oesophageal echocardiogram (TOE) did not reveal vegetation, but showed an elevated aortic valve gradient of 70 mmHg consistent with severe aortic stenosis. A repeat TOE revealed multiple mobile and immobile mitral and aortic valve vegetations with an abscess extending toward the aortic valve. Three sets of positive blood cultures from admission identified . Antibiotics were tailored to ceftriaxone. He underwent urgent aortic and mitral valve replacement. He completed a 6-week course of ceftriaxone. At discharge, two-dimensional echo revealed normal heart function with normal prosthetic mitral and aortic valves.

Conclusion:

is an uncommon, but increasingly recognized, cause of infective endocarditis. It causes severe valvular destruction with systemic complications and often requires surgical intervention.

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2015-10-30
2019-10-19
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