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Thoracic Osteomyelitis and Eustachian Valve Endocarditis: A Case Report and Literature Review

Sheila D Hernandez1, Maxwell J Jabaay2, Dario A Marotta2,3

  • 1Internal Medicine Residency Program, Southeast Health, Dothan, USA.

Cureus
|April 16, 2021
PubMed

Insights

This case report details a rare instance of methicillin-resistant Staphylococcus aureus (MRSA) causing both vertebral osteomyelitis and eustachian valve endocarditis. It highlights treatment considerations for this unusual combination of serious infections.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Orthopedic Surgery

Background:

  • Infective endocarditis and vertebral osteomyelitis are uncommon infections, frequently caused by Staphylococcus aureus.
  • The eustachian valve, an embryological remnant, can be a site for infective endocarditis, though rarely documented.
  • Concomitant eustachian valve endocarditis and vertebral osteomyelitis is exceptionally rare.

Observation:

  • A 43-year-old male presented with vertebral osteomyelitis attributed to methicillin-resistant Staphylococcus aureus (MRSA).
  • Persistent bacteremia was noted in the patient.
  • Vegetative growth was identified on a eustachian valve remnant during investigation.

Findings:

  • This case documents the first instance of eustachian valve endocarditis occurring with MRSA-induced vertebral osteomyelitis.
  • Successful management involved addressing both the endocarditis and osteomyelitis.

Implications:

  • This report expands the understanding of rare infective endocarditis presentations.
  • It provides valuable insights into managing MRSA eustachian valve endocarditis alongside vertebral osteomyelitis.
  • Highlights the importance of considering unusual cardiac involvements in persistent bacteremia cases.
Keywords:
embryological remnantendocarditiseustachian valveosteomyelitis

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