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Native valve endocarditis caused by Kocuria rosea complicated by peripheral mycotic aneurysm in an elderly host
P Gunaseelan1, G Suresh2, V Raghavan2
1Department of Family Medicine, Sundaram Medical Foundation, Chennai, Tamil Nadu, India.
Abstract:
Infective endocarditis still remains a dreaded illness among treating physicians because of the disease course, its need for meticulous antibiotic management, complications, and overall morbidity. Peripheral mycotic aneurysms are a rarely reported complication of infective endocarditis. Mycotic aneurysms occur in about 5%-10% of cases of infective endocarditis, and most of them involve the intracranial vessels. Here, we report a case of native valve endocarditis in a 74-year-old man caused by Kocuria rosea. He presented with septic shock and acute kidney injury. His illness was complicated by a right popliteal artery mycotic aneurysm. He was treated with intravenous ceftriaxone and vancomycin. The mycotic aneurysm needed aneurysmectomy and anastomosis with a graft.
Insights
Infective endocarditis can lead to rare peripheral mycotic aneurysms, as seen with Kocuria rosea. This case highlights the need for prompt diagnosis and surgical intervention for limb-threatening complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- Infective endocarditis (IE) poses significant clinical challenges due to its complex management and potential for severe complications.
- Peripheral mycotic aneurysms are uncommon manifestations of IE, with intracranial involvement being most frequent.
Observation:
- A 74-year-old male with native valve endocarditis caused by Kocuria rosea presented with septic shock and acute kidney injury.
- The patient developed a rare complication: a mycotic aneurysm of the right popliteal artery.
Findings:
- Successful treatment involved intravenous antibiotics (ceftriaxone and vancomycin).
- Surgical intervention, including aneurysmectomy and graft anastomosis, was necessary to manage the popliteal artery mycotic aneurysm.
Implications:
- This case underscores the importance of considering peripheral vascular complications in IE patients.
- Early recognition and multidisciplinary management are crucial for improving outcomes in patients with infective endocarditis and associated mycotic aneurysms.