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Culture-negative infective endocarditis caused by Aerococcus urinae
Michal Slany1, Tomas Freiberger, Petr Pavlik
1Centrefor Cardiovascular Surgery and Transplantation, Brno, Czech Republic.
The Journal of Heart Valve Disease
|May 9, 2007
Summary
Aerococcus urinae, a rare urinary tract infection pathogen, can cause severe endocarditis. Early identification and appropriate antibiotic treatment are crucial for patient survival and recovery.
Area of Science:
- Microbiology
- Infectious Diseases
- Cardiology
Background:
- Aerococcus urinae is an uncommon pathogen frequently causing urinary tract infections (UTIs).
- While typically causing mild UTIs, A. urinae has been linked to severe conditions like endocarditis and septicemia.
- This bacterium exhibits resistance to sulfonamides, complicating standard UTI treatment protocols.
Observation:
- A case of blood culture-negative infective endocarditis (IE) in a 69-year-old male is presented.
- The patient had predisposing factors for UTI, a common characteristic in reported A. urinae IE cases.
- A. urinae can be challenging to detect and misidentified by commercial diagnostic systems.
Findings:
- The causative agent, A. urinae, was identified from excised heart valve tissue using broad-range bacterial PCR and 16S rRNA gene sequencing.
- The patient successfully recovered following aortic valve replacement and a prolonged course of ceftriaxone and cefuroxime.
- This case highlights the successful diagnosis and treatment of a rare, severe A. urinae infection.
Implications:
- Accurate identification of A. urinae is critical, as it requires specific antibiotic therapy.
- Prompt diagnosis and intervention, including surgical management and targeted antibiotics, can lead to favorable outcomes in severe A. urinae IE.
- Further research into diagnostic methods and treatment strategies for A. urinae infections is warranted.
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