Prevotella bivia cardiac implantable electronic device related endocarditis

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Gram-negative anaerobic bacteremia and endocarditis are rising, particularly in patients with polymicrobial infections, such as injection drug users and those with diabetes mellitus.
• Cardiac implantable electronic device (CIED)-related endocarditis is a serious complication, with limited reports involving Gram-negative anaerobic organisms.

Observation:

• A unique case of Prevotella bivia CIED-related endocarditis is presented in a middle-aged woman with no history of injection drug use.
• This presentation is unusual given the typical patient profiles associated with such infections.

Findings:

• Prevotella bivia, a Gram-negative anaerobic bacterium, was identified as the causative agent of CIED-related endocarditis.
• The case underscores the broadening spectrum of pathogens implicated in CIED infections and endocarditis.

Implications:

• This case highlights the increasing incidence of polymicrobial infections and anaerobic endocarditis.
• It demonstrates Prevotella bivia's capacity to cause both native valve infective endocarditis and CIED-related endocarditis.
• Clinicians should consider anaerobic Gram-negative bacteria in the differential diagnosis of CIED infections, even in atypical patient populations.