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Polymicrobial native valve endocarditis due to Bacillus cereus and Cardiobacterium hominis

Sherin Meledathu1, Rachel Denyer2, Afsoon Roberts2

  • 1Infectious Disease, The George Washington University Hospital, Washington, DC, USA rindathu@gmail.com.

BMJ Case Reports
|December 2, 2021
PubMed

Insights

This case report details a rare polymicrobial endocarditis caused by Bacillus cereus and Cardiobacterium hominis. It highlights challenges in managing Bacillus infections due to antibiotic resistance.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Nephrology

Background:

  • Subacute bacterial endocarditis is a serious infection affecting heart valves.
  • Polymicrobial endocarditis is uncommon, often involving Staphylococcus species.
  • Bacillus cereus is typically a blood culture contaminant, rarely causing invasive infections like endocarditis.

Observation:

  • A 72-year-old male with mitral valve disease presented with renal failure and glomerulonephritis.
  • Blood cultures revealed polymicrobial bacteremia with Bacillus cereus and Cardiobacterium hominis.
  • The patient had pre-existing mitral valve disease and prior valve repair.

Findings:

  • This is the first reported case of polymicrobial endocarditis involving both Bacillus and a HACEK organism (Cardiobacterium hominis).
  • Bacillus cereus exhibited resistance to penicillin and cephalosporins due to beta-lactamase production.
  • The patient's presentation included renal failure and glomerulonephritis secondary to endocarditis.

Implications:

  • This case expands the understanding of polymicrobial endocarditis etiologies.
  • It underscores the importance of considering Bacillus cereus in invasive infections, especially in at-risk patients.
  • Management strategies for Bacillus endocarditis require careful consideration of antibiotic resistance patterns.

Keywords:
drugs: infectious diseasesinfectious diseasesvalvar diseases

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