%0 Journal Article %A Kwok, T'ng Choong %A Poyner, Jennifer %A Olson, Ewan %A Henriksen, Peter %A Koch, Oliver %T Staphylococcus caprae native mitral valve infective endocarditis %D 2016 %J JMM Case Reports, %V 3 %N 5 %@ 2053-3721 %C e005065 %R https://doi.org/10.1099/jmmcr.0.005065 %K Staphylococcus caprae %K coagulase negative staphylococcus %K occult prosthetic metalwork infection %K native valve %K conservative management %I Microbiology Society, %X Introduction: Staphylococcus caprae is a rare cause of infective endocarditis. Here, we report a case involving the native mitral valve in the absence of an implantable cardiac electronic device. Case presentation: A 76-year-old man presented with a 2 week history of confusion and pyrexia. His past medical history included an open reduction and internal fixation of a humeral fracture 17 years previously, which remained non-united despite further revision 4 years later. There was no history of immunocompromise or farm-animal contact. Two sets of blood culture bottles, more than 12 h apart, were positive for S. caprae. Trans-thoracic echocardiography revealed a 1×1.2 cm vegetation on the mitral valve, with moderate mitral regurgitation. Due to ongoing confusion, he had a magnetic resonance imaging brain scan, which showed a subacute small vessel infarct consistent with a thromboembolic source. A humeral SPECT-CT (single-photon emission computerized tomography-computerized tomography) scan showed no clear evidence of acute osteomyelitis. Surgical vegetectomy and mitral-valve repair were considered to reduce the risk of further systemic embolism and progressive valve infection. However, the potential risks of surgery to this patient led to a decision to pursue a cure with antibiotic therapy alone. He remained well 3 months after discharge, with repeat echocardiography demonstrating a reduction in the size of the vegetation (0.9 cm). Conclusion: Management of this infection was challenging due to its rarity and its unclear progression, complicated by the dilemma surrounding surgical intervention in a patient with a complex medical background. %U https://www.microbiologyresearch.org/content/journal/jmmcr/10.1099/jmmcr.0.005065