Escherichia coli prosthetic valve endocarditis from a non-genitourinary source

Escherichia coli (E. coli) is a rare cause of infective endocarditis due to its lack of traditional virulence factors that promote endocardial adherence. Previous case reports of E. coli infective endocarditis demonstrate specific risk factors to include advanced age over 70, female sex, diabetes, i...

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Autores principales:	Robert Quiring, Victoria Burke
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Infective endocarditis Prosthetic valve Escherichia coli Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/22b6e05f8e14436ba2bee7e0a2941ce8
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spelling	oai:doaj.org-article:22b6e05f8e14436ba2bee7e0a2941ce82021-11-12T04:33:57ZEscherichia coli prosthetic valve endocarditis from a non-genitourinary source2214-250910.1016/j.idcr.2021.e01329https://doaj.org/article/22b6e05f8e14436ba2bee7e0a2941ce82021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2214250921002857https://doaj.org/toc/2214-2509Escherichia coli (E. coli) is a rare cause of infective endocarditis due to its lack of traditional virulence factors that promote endocardial adherence. Previous case reports of E. coli infective endocarditis demonstrate specific risk factors to include advanced age over 70, female sex, diabetes, immunosuppression, and intravascular or cardiac devices. Antecedent genitourinary infection is the most common source. 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 transesophageal echocardiogram (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 trimethoprim-sulfamethoxazole suppressive therapy with serial echocardiographic follow-up given the persistent small vegetation on repeat echocardiogram. Our case report and review of ten recent cases of prosthetic valve endocarditis described in the literature illustrates several common features of the epidemiology, presentation, and management of E. coli prosthetic valve endocarditis including more commonly reported non-genitourinary sources of bacteremia, a trend towards more frequent surgical interventions, and a declining mortality rate.Robert QuiringVictoria BurkeElsevierarticleInfective endocarditisProsthetic valveEscherichia coliInfectious and parasitic diseasesRC109-216ENIDCases, Vol 26, Iss , Pp e01329- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infective endocarditis Prosthetic valve Escherichia coli Infectious and parasitic diseases RC109-216
spellingShingle	Infective endocarditis Prosthetic valve Escherichia coli Infectious and parasitic diseases RC109-216 Robert Quiring Victoria Burke Escherichia coli prosthetic valve endocarditis from a non-genitourinary source
description	Escherichia coli (E. coli) is a rare cause of infective endocarditis due to its lack of traditional virulence factors that promote endocardial adherence. Previous case reports of E. coli infective endocarditis demonstrate specific risk factors to include advanced age over 70, female sex, diabetes, immunosuppression, and intravascular or cardiac devices. Antecedent genitourinary infection is the most common source. 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 transesophageal echocardiogram (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 trimethoprim-sulfamethoxazole suppressive therapy with serial echocardiographic follow-up given the persistent small vegetation on repeat echocardiogram. Our case report and review of ten recent cases of prosthetic valve endocarditis described in the literature illustrates several common features of the epidemiology, presentation, and management of E. coli prosthetic valve endocarditis including more commonly reported non-genitourinary sources of bacteremia, a trend towards more frequent surgical interventions, and a declining mortality rate.
format	article
author	Robert Quiring Victoria Burke
author_facet	Robert Quiring Victoria Burke
author_sort	Robert Quiring
title	Escherichia coli prosthetic valve endocarditis from a non-genitourinary source
title_short	Escherichia coli prosthetic valve endocarditis from a non-genitourinary source
title_full	Escherichia coli prosthetic valve endocarditis from a non-genitourinary source
title_fullStr	Escherichia coli prosthetic valve endocarditis from a non-genitourinary source
title_full_unstemmed	Escherichia coli prosthetic valve endocarditis from a non-genitourinary source
title_sort	escherichia coli prosthetic valve endocarditis from a non-genitourinary source
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/22b6e05f8e14436ba2bee7e0a2941ce8
work_keys_str_mv	AT robertquiring escherichiacoliprostheticvalveendocarditisfromanongenitourinarysource AT victoriaburke escherichiacoliprostheticvalveendocarditisfromanongenitourinarysource
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Escherichia coli prosthetic valve endocarditis from a non-genitourinary source

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