Early-onset Streptomyces endocarditis in a prosthetic aortic valve

Area of Science:

• Cardiology
• Infectious Diseases
• Microbiology

Background:

• Aortic valve stenosis necessitates prosthetic valve replacement for improved hemodynamics.
• Mechanical valves, such as the Medtronic-Hall, are commonly used but can be susceptible to complications.

Observation:

• A patient developed dyspnea, fever, and anemia six weeks post-aortic valve replacement.
• Clinical findings included pulmonary edema and moderate periprosthetic aortic regurgitation.

Findings:

• Infective endocarditis was diagnosed, originating below the right coronary artery orifice.
• Bacteriological analysis identified a rare Streptomyces species as the causative agent.
• Intensive antibiotic therapy led to the resolution of infection and aortic regurgitation.

Implications:

• This case highlights the potential for rare bacterial infections to complicate prosthetic valve surgery.
• Early diagnosis and targeted antibiotic treatment are crucial for managing prosthetic valve endocarditis.
• Streptomyces species should be considered in the differential diagnosis of culture-negative endocarditis.