A case of subacute infective endocarditis and blood access infection caused by Enterococcus durans

Area of Science:

• Infectious Diseases
• Cardiology
• Nephrology

Background:

• Enterococcus durans (E. durans) infections are infrequently reported, typically in immunocompromised individuals or those with pre-existing conditions like infective endocarditis or wound infections.
• While E. durans endocarditis cases are documented, concurrent blood access infections have not been previously described.

Observation:

• An 83-year-old male undergoing long-term hemodialysis for diabetic nephropathy developed concurrent infective endocarditis and a blood access infection/infective aneurysm.
• The causative agent identified was Enterococcus durans.

Findings:

• This case represents the first documented instance of Enterococcus durans causing both infective endocarditis and a blood access infection/infective aneurysm.
• The patient was successfully treated with ampicillin plus gentamicin.

Implications:

• Highlights the potential for E. durans to cause complex, concurrent infections in vulnerable patient populations, such as those on hemodialysis.
• Underscores the importance of considering rare pathogens in the diagnosis and management of infections associated with medical devices and vascular access.
• Suggests the need for increased awareness and potentially revised diagnostic or treatment guidelines for E. durans-related bloodstream and access site infections.