Lactococcus garvieae: An Uncommon Human Pathogen Causing Infective Endocarditis in a Valve-in-Valve Transcatheter...

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Lactococcus garvieae is an emerging fish pathogen and an uncommon cause of human infections.
• Evidence suggests L. garvieae has the potential to cause endocarditis, especially in patients with prior valve surgery.

Observation:

• This report details the first case of L. garvieae endocarditis in a valve-in-valve transcatheter aortic valve replacement (VIV-TAVR).
• The patient presented with L. garvieae bacteremia and prosthetic valve endocarditis.

Findings:

• Successful treatment was achieved with a prolonged 6-week antibiotic course.
• Surgery was avoided due to the absence of prosthetic aortic valve dysfunction and paravalvular infection extension.

Implications:

• This case underscores the importance of considering L. garvieae endocarditis in patients with bacteremia and prosthetic valves, even if not meeting Duke Criteria.
• Advanced imaging like transesophageal echocardiogram, PET-CT, or MRI is crucial for diagnosis, especially with negative initial transthoracic echocardiograms.
• The findings contribute to managing this rare but life-threatening infection and inform future patient care guidelines.