Cerebral vasculitis and Cardiobacterium valvarum endocarditis

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Native valve endocarditis (NVE) is typically caused by Gram-positive bacteria.
• Gram-negative bacilli are infrequent etiological agents of NVE, posing diagnostic and therapeutic challenges.

Observation:

• A 65-year-old male presented with aortic and tricuspid native valve endocarditis.
• Blood cultures isolated Cardiobacterium valvarum, a fastidious Gram-negative bacillus.
• The patient experienced cerebral vasculitis, a rare complication.

Findings:

• This is the first reported fatality of Cardiobacterium valvarum endocarditis prior to surgical intervention.
• This case represents the first documented instance of cerebral vasculitis associated with Cardiobacterium valvarum infection.
• Identification of Cardiobacterium species may necessitate advanced molecular techniques in reference laboratories.

Implications:

• Highlights the potential for rare Gram-negative bacilli to cause severe NVE.
• Underscores the importance of considering unusual pathogens in culture-negative or treatment-refractory endocarditis.
• Emphasizes the need for specialized diagnostic capabilities for identifying fastidious microorganisms.