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Achromobacter xylosoxidans subsp. xylosoxidans prosthetic aortic valve infective endocarditis and aortic root

S van Hal1, D Stark1, D Marriott1

  • 1Department of Microbiology, St Vincent's Hospital, Darlinghurst 2010, NSW Sydney, Australia.

Journal of Medical Microbiology
|March 20, 2008
PubMed

Insights

Achromobacter xylosoxidans caused prosthetic valve endocarditis and aortic root abscesses in an intravenous drug user. Prompt surgical intervention and meropenem treatment led to a full recovery.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Prosthetic valve endocarditis (PVE) is a serious complication following cardiac valve replacement surgery.
  • Achromobacter xylosoxidans is an opportunistic Gram-negative bacterium increasingly recognized in clinical settings.
  • Intravenous drug use is a known risk factor for infective endocarditis.

Observation:

  • A case of PVE and aortic root abscesses is presented.
  • The causative agent was identified as Achromobacter xylosoxidans subsp. xylosoxidans.
  • The patient reported a history of intravenous drug use, specifically injecting amphetamines diluted with 'duck pond water'.

Findings:

  • Surgical intervention was performed to address the prosthetic valve endocarditis and abscesses.
  • Intravenous meropenem therapy was administered for a duration of 6 weeks.
  • The patient experienced an uneventful recovery following treatment.

Implications:

  • This case highlights the potential for Achromobacter xylosoxidans to cause severe invasive infections, including PVE.
  • Contaminated diluents used in intravenous drug preparation can serve as a source of unusual bacterial pathogens.
  • Aggressive management involving surgery and appropriate antibiotic therapy is crucial for favorable outcomes in such complex cases.

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