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A Rarely Reported Case of Enterococcus faecalis Bacteremia Causing Infective Endocarditis and Osteomyelitis
Pradeep Kumar Devarakonda1, Vishal R Dhulipala2,3, Monika Karki1
1Internal Medicine, The Brooklyn Hospital Center, Brooklyn, USA.
Cureus
|March 29, 2022
Summary
This case highlights a rare instance of Enterococcus faecalis endocarditis complicated by osteomyelitis in a 63-year-old male. The patient successfully underwent aortic valve replacement following diagnosis.
Area of Science:
- Cardiology
- Infectious Diseases
- Orthopedics
Background:
- Infective endocarditis (IE) involves heart valve or endocardium infection, often from bloodstream pathogens.
- Enterococci, common gut flora, can cause serious infections like IE, particularly in elderly patients.
- Enterococcus faecalis endocarditis is uncommon, and its complication with osteomyelitis is exceedingly rare.
Observation:
- A 63-year-old male with prior cardiac arrest and medical device placements presented with back pain.
- Magnetic resonance imaging revealed osteomyelitis, while transthoracic echocardiography showed aortic valve vegetations.
- Blood cultures confirmed Enterococcus faecalis bacteremia.
Findings:
- The patient had a rare combination of E. faecalis infective endocarditis and osteomyelitis.
- Repeat echocardiography demonstrated vegetation growth, necessitating intervention.
- Surgical intervention included bioprosthetic aortic valve replacement.
Implications:
- This case underscores the importance of considering Enterococcus faecalis in complex IE cases, especially with contiguous spread.
- Prompt diagnosis and surgical management are crucial for favorable outcomes in such rare presentations.
- Further research into risk factors and treatment strategies for E. faecalis IE with osteomyelitis is warranted.
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