Medically managed prosthetic valve endocarditis caused by Salmonella enteritidis

Infective endocarditis is associated with morbidity and mortality even when appropriately treated. It can be more complicated to treat when prosthetic material is present, often necessitating surgical revision as well as antimicrobial therapy. Endocarditis caused by gram-negative bacilli is a rare o...

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Bibliographic Details
Published in:BMJ case reports 2021-06, Vol.14 (6), p.e237679
Main Authors: Connolly, Gavin, Kale, Mita, Ustianowski, Andrew
Format: Article
Language:English
Subjects:
Abdomen
Anti-Bacterial Agents - therapeutic use
Antibiotics
Antimicrobial agents
Blood pressure
Case Report
Case reports
Diarrhea
Dyspnea
Endocarditis
Endocarditis - diagnosis
Endocarditis - drug therapy
Endocarditis, Bacterial - diagnosis
Endocarditis, Bacterial - drug therapy
Fever
Heart Valve Prosthesis - adverse effects
Hemoglobin
Hospitals
Humans
Infections
Potassium
Prostheses
Prosthesis-Related Infections - drug therapy
Salmonella
Salmonella enteritidis
Sepsis
Sweating
Ultrasonic imaging
Urogenital system
Vegetation
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Summary:Infective endocarditis is associated with morbidity and mortality even when appropriately treated. It can be more complicated to treat when prosthetic material is present, often necessitating surgical revision as well as antimicrobial therapy. Endocarditis caused by gram-negative bacilli is a rare occurrence, with some literature and expert opinion suggesting superior outcomes with combined surgery and antibiotics when a prosthetic valve is involved. In cases where the prosthetic valve is well-functioning and undamaged, or cardiothoracic surgery represents a significant operative risk, it can be unclear how best to proceed. This report documents a case of Salmonella enterica subspecies enterica serovar enteritidis endocarditis of a mechanical mitral valve. The patient was managed with 6 weeks of intravenous antibiotics followed by suppressive oral antibiotic therapy. They remain in good health at 24 months.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-237679