Elusive Enterobacter cloacae causing pacemaker endocarditis

Area of Science:

• Infectious Diseases
• Cardiology
• Medical Case Reports

Background:

• Endocarditis is a serious infection of the heart's inner lining or valves.
• Gram-negative bacteria, particularly non-HACEK organisms, are uncommon causes of infective endocarditis.
• Pacemaker implantation is a known risk factor for device-related infections.

Observation:

• An 80-year-old patient presented with fever, chills, and chest pain.
• Infective endocarditis caused by Enterobacter cloacae was diagnosed, involving pacemaker leads and the mitral valve.
• The source of infection remained unidentified.

Findings:

• Enterobacter cloacae, a non-HACEK gram-negative bacterium, was identified as the causative agent.
• The patient received an unconventional treatment regimen.
• The treatment approach resulted in a successful clinical outcome.

Implications:

• This case underscores Enterobacter cloacae as an uncommon but significant cause of endocarditis with potentially high mortality.
• It highlights the importance of considering non-HACEK gram-negative organisms in endocarditis diagnosis.
• The successful unconventional management suggests alternative therapeutic strategies may be viable for complex cases.