Escherichia coli endocarditis of a native mitral valve

Escherichia coli (E.coli) is a rare cause of endocarditis, although is a common causative agent of bacteremia. An 89-year-old woman presented with recurrent episodes of fever and persistent E. coli bacteremia with 3-month duration, despite antimicrobial therapy. At first, a urinary tract infection w...

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Bibliographic Details
Published in:IDCases 2019-01, Vol.17, p.e00548, Article e00548
Main Authors: Nogueira, Ana Rita, Brazão, Sofia, Ferreira, Diana, Aragão, António, Veríssimo, Manuel Teixeira, Carvalho, Armando
Format: Article
Language:English
Subjects:
Endocarditis
Escherichia coli
Gram-negative bacteria
Native valve
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Summary:Escherichia coli (E.coli) is a rare cause of endocarditis, although is a common causative agent of bacteremia. An 89-year-old woman presented with recurrent episodes of fever and persistent E. coli bacteremia with 3-month duration, despite antimicrobial therapy. At first, a urinary tract infection was diagnosed and later a mycotic aneurysm of the abdominal aorta was found and required an endovascular repair. The persistence of fever and the evidence of a systolic murmur at the mitral focus raised the suspicion of endocarditis. A transesophageal echocardiogram and a cardiac Magnetic Resonance Imaging (MRI) confirmed the presence of a vegetation at the mitral valve and the patient was treated with ceftriaxone. The presence of comorbid conditions and certain bacterial virulence factors predispose to this rare condition. A high level of suspicion is important to early diagnosis and prompt therapy.
ISSN:2214-2509
2214-2509
DOI:10.1016/j.idcr.2019.e00548