Multi-territory ischaemic strokes and subacute bacterial endocarditis

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Infective endocarditis (IE) is a serious infection of the heart's inner lining, often associated with significant morbidity and mortality.
• Cardio-embolic stroke is a common complication of cardiac conditions, including IE, leading to neurological deficits.
• Facklamia species are gram-positive bacteria rarely implicated in human infections.

Observation:

• An elderly patient presented with symptoms suggestive of cardio-embolic stroke.
• Cardiac evaluation revealed infective endocarditis (IE) involving the mitral valve.
• Blood cultures identified penicillin-resistant Facklamia hominis as the causative agent.

Findings:

• This case represents the first reported instance of Facklamia hominis causing infective endocarditis (IE).
• The patient experienced a fatal myocardial infarction despite aggressive antibiotic therapy, underscoring the severity of IE and its complications.
• The study emphasizes the potential link between IE and cardio-embolic stroke, even with unusual pathogens.

Implications:

• The findings expand the spectrum of pathogens associated with infective endocarditis (IE).
• This case highlights the importance of considering rare bacteria in the diagnosis of IE, particularly in patients with stroke.
• Further research is warranted to understand the pathogenicity of Facklamia species and their role in cardiovascular infections.