Presentation Date
19-10-2021 12:00 AM
Description
Introduction: E. coli is a rare cause of infective endocarditis due to its lack of traditional virulence factors that promote endocardial adherence. Antecedent genitourinary infection is the most common source. Case: We present a case of a 55-year-old Honduran man with a recent bioprosthetic mitral valve replacement and tricuspid valve repair who presented with one month of subjective fevers, night sweats, anorexia, and significant weight loss. After extensive work-up, the patient was diagnosed with E. coli infective endocarditis secondary to E. coli growth in blood cultures and a TEE revealing a vegetation on his prosthetic mitral valve. An indolent gastrointestinal source was suspected to be the source of infection with imaging only notable for mild periappendiceal stranding concerning for a possible site of antecedent inflammation. He was treated with a 6- week course of ceftriaxone and gentamicin inpatient and then discharged on life-long trimethoprim-sulfamethoxazole suppressive therapy. Discussion: Our case report and literature review of the most recent cases of prosthetic valve endocarditis in the last 20 years illustrate several common features of the changing epidemiology of E. coli prosthetic valve endocarditis. Some of these evident changes include a more even gender distribution of disease, less prevalent genitourinary sources leading to septicemia, a trend towards more frequent surgical interventions, and a declining mortality rate. Conclusion: Clinicians should be aware of the changing epidemiology of E.coli prosthetic valve endocarditis and consider sources beyond the historically most prevalent genitourinary etiology.
Recommended Citation
Quiring, Robert and Burke, Victoria, "Escherichia coli prosthetic valve endocarditis from a non-genitourinary source: a case reportand review of the literature" (2021). Medical Research Day. 90.
https://digitalscholar.lsuhsc.edu/sommrd/2021MRD/Posters/90
Included in
Escherichia coli prosthetic valve endocarditis from a non-genitourinary source: a case reportand review of the literature
Introduction: E. coli is a rare cause of infective endocarditis due to its lack of traditional virulence factors that promote endocardial adherence. Antecedent genitourinary infection is the most common source. Case: We present a case of a 55-year-old Honduran man with a recent bioprosthetic mitral valve replacement and tricuspid valve repair who presented with one month of subjective fevers, night sweats, anorexia, and significant weight loss. After extensive work-up, the patient was diagnosed with E. coli infective endocarditis secondary to E. coli growth in blood cultures and a TEE revealing a vegetation on his prosthetic mitral valve. An indolent gastrointestinal source was suspected to be the source of infection with imaging only notable for mild periappendiceal stranding concerning for a possible site of antecedent inflammation. He was treated with a 6- week course of ceftriaxone and gentamicin inpatient and then discharged on life-long trimethoprim-sulfamethoxazole suppressive therapy. Discussion: Our case report and literature review of the most recent cases of prosthetic valve endocarditis in the last 20 years illustrate several common features of the changing epidemiology of E. coli prosthetic valve endocarditis. Some of these evident changes include a more even gender distribution of disease, less prevalent genitourinary sources leading to septicemia, a trend towards more frequent surgical interventions, and a declining mortality rate. Conclusion: Clinicians should be aware of the changing epidemiology of E.coli prosthetic valve endocarditis and consider sources beyond the historically most prevalent genitourinary etiology.