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Prosthetic aortic valve dehiscence following infective endocarditis by a rare bacterium - Pandoraea pnomenusa

Atit A Gawalkar1, Ganesh Kasinadhuni1, Rimjhim Kanaujia2

  • 1Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160 012, India.

Journal of Cardiology Cases
|July 14, 2021
PubMed

Insights

Late prosthetic valve endocarditis (PVE) can be caused by rare bacteria. This case highlights a rare gram-negative bacterium, Pandoraea pnomenusa, causing PVE in an aortic prosthetic valve.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Late prosthetic valve endocarditis (PVE) is a severe complication of cardiac valve replacement surgery.
  • Commonly caused by staphylococci, streptococci, or enterococci, PVE can also result from rare pathogens.
  • Early diagnosis and management are crucial for patient outcomes.

Observation:

  • A case of late PVE affecting an aortic prosthetic valve is presented.
  • The causative agent was identified as the rare gram-negative bacterium *Pandoraea pnomenusa*.
  • This represents the first reported instance of PVE attributed to this specific organism.

Findings:

  • The patient presented with prosthetic valve dehiscence, severe aortic regurgitation, and shock.
  • Infective endocarditis was confirmed as the cause of the prosthetic valve complications.
  • Treatment involved appropriate antibiotics and supportive medical care.

Implications:

  • This case underscores the importance of considering rare organisms in the differential diagnosis of PVE.
  • Physicians should maintain a high index of suspicion for PVE in patients with prosthetic valves presenting with heart failure symptoms.
  • Expanding the understanding of etiological agents in PVE is vital for effective treatment strategies.
Keywords:
Aortic valve dehiscenceInfective endocarditisPandoraea pnomenusaPara-valvular regurgitationProsthetic valve endocarditis

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