Campylobacter fetus prosthetic valve endocarditis presenting as a stroke

Area of Science:

• Infectious Diseases
• Cardiology
• Neurology

Background:

• Campylobacter fetus is an uncommon cause of invasive infections, typically affecting the vascular endothelium.
• Prosthetic valve endocarditis (PVE) due to C. fetus is exceedingly rare, with limited literature available.
• This study presents a unique case of C. fetus PVE with neurological complications.

Observation:

• An 85-year-old female with a history of tissue aortic valve replacement presented with stroke-like symptoms.
• Blood cultures and echocardiography confirmed prosthetic valve endocarditis caused by C. fetus.
• Cerebral emboli were identified on MRI, indicating a potential link between the endocarditis and neurological events.

Findings:

• This is the sixth reported case of C. fetus PVE and the first to present primarily as a stroke.
• The patient successfully responded to a 6-week course of amoxicillin and 2-week course of gentamicin.
• Most reported survivors of C. fetus PVE required valve replacement surgery.

Implications:

• This case adds to the limited literature on managing C. fetus endocarditis, particularly in prosthetic valves.
• The presentation as a stroke highlights the potential for severe neurological complications.
• Further research is needed to establish guidelines for the optimal treatment of C. fetus endocarditis, as surgical intervention may not always be necessary.