Device-associated aortic valve endocarditis due to a complicated Enterobacter cloacae urinary tract infection

Area of Science:

• Cardiology
• Infectious Diseases
• Internal Medicine

Background:

• Infective endocarditis (IE) incidence is rising, with Staphylococci and Streptococci as common causes.
• Rarer organisms are increasingly implicated in IE, often presenting with aggressive disease courses.
• Multidrug-resistant (MDR) gram-negative bacteria pose a significant challenge in IE management.

Observation:

• A case of aortic valve IE caused by Enterobacter cloacae in an 82-year-old male with a permanent pacemaker is presented.
• The patient had a history of multidrug-resistant gram-negative organism infection.
• The infection involved the aortic valve, a critical site for endocarditis.

Findings:

• Enterobacter cloacae, a multidrug-resistant gram-negative organism, was identified as the causative agent of IE.
• A prolonged course of beta-lactam therapy was administered.
• Clinical improvement and successful non-invasive management were observed.

Implications:

• Prolonged beta-lactam therapy may represent an effective non-invasive treatment strategy for IE caused by MDR gram-negative organisms.
• This case broadens the therapeutic options for complex IE cases.
• Further research into beta-lactam efficacy for MDR gram-negative IE is warranted.