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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Proteus mirabilis endocarditis.

Inês Albuquerque1, Ana Rita Silva2, Marta Soares Carreira1

  • 1Internal Medicine, Centro Hospitalar de Sao Joao EPE, Porto, Portugal.

BMJ Case Reports
|August 31, 2019
PubMed
Summary
This summary is machine-generated.

A rare case of infective endocarditis caused by Proteus mirabilis in an immunocompromised patient is presented. Prompt diagnosis and targeted antibiotic therapy led to successful treatment and valve replacement.

Keywords:
infectionsvalvar diseases

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Transplantation

Background:

  • Immunocompromised status in an hepatic transplant recipient on everolimus.
  • History of prosthetic valve replacement (mitral and aortic) 4 years prior.
  • Presentation with fever and acute heart failure.

Observation:

  • Severe aortic valve obstruction on transthoracic echocardiogram.
  • Pulmonary infiltrates on computed tomography (CT) without septic embolization.
  • Negative blood cultures but Proteus mirabilis isolated from bronchial lavage.

Findings:

  • Severe aortic regurgitation on transesophageal echocardiogram, with no definitive endocarditis findings.
  • Proteus mirabilis identified in the explanted aortic valve during re-operation.
  • Successful treatment with dual antibiotic therapy for 6 weeks post-valve replacement.

Implications:

  • Highlights the importance of considering uncommon pathogens like Proteus mirabilis in immunocompromised patients with prosthetic valves.
  • Demonstrates the diagnostic challenge of infective endocarditis with negative blood cultures.
  • Emphasizes the need for tailored antibiotic strategies and surgical intervention in complex cases.