A rare native mitral valve endocarditis successfully treated after surgical correction.

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Mycobacterium abscessus and Kocuria species are uncommon pathogens causing human infections.
• Endocarditis due to these organisms is exceptionally rare, with limited documented cases.
• Native valve endocarditis presents unique challenges, particularly with resistant microbial strains.

Observation:

• A 48-year-old male with a history of intravenous drug use presented with native mitral valve endocarditis.
• The infection was concurrently caused by Mycobacterium abscessus and Kocuria species.
• A significant complication was the perforation of the posterior mitral valve leaflet, necessitating surgical intervention.

Findings:

• Blood and mitral valve cultures confirmed the presence of both M. abscessus and Kocuria species.
• The patient underwent successful mitral valve replacement surgery.
• A 6-month antibiotic treatment including clarithromycin, imipenem, and amikacin led to symptom resolution and negative blood cultures.

Implications:

• This case highlights the importance of considering acid-fast staining for identifying rapidly growing mycobacteria in subacute endocarditis.
• Effective management of M. abscessus and Kocuria endocarditis requires a multi-modal approach, including prolonged antibiotics and potentially surgery.
• Further research into the pathogenesis and treatment strategies for rare bacterial endocarditis is warranted.