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Rare Proteus mirabilis Aortic Valve Infective Endocarditis without a Urinary Tract Infection
Sarah Gorn1, Nicholas Talley1, Austin Mitchell1
1Midwestern University, Mountain Vista Medical Center, Mesa, AZ, USA.
Case Reports in Infectious Diseases
|January 10, 2023
Summary
Proteus mirabilis infective endocarditis is rare, often linked to urinary issues. This case highlights a patient with negative urine cultures but positive blood cultures, emphasizing atypical presentations of this serious infection.
Area of Science:
- Infectious Diseases
- Cardiology
- Nephrology
Background:
- Proteus mirabilis infective endocarditis is exceptionally rare, with limited documented cases.
- This condition is frequently associated with urinary tract infections (UTIs), staghorn calculi, or asymptomatic bacteriuria.
Observation:
- A 73-year-old male presented with positive blood cultures for Proteus mirabilis.
- Despite positive blood cultures, urinalysis and initial urine culture were negative.
- The patient experienced acute renal failure necessitating hemodialysis.
Findings:
- Transthoracic echocardiography (TTE) revealed a reduced ejection fraction of 30% without visualized vegetations.
- Transesophageal echocardiography (TEE) identified a small vegetation on the left aortic valve.
- Urine cultures remained negative throughout the patient's hospital stay.
Implications:
- This case underscores the importance of considering Proteus mirabilis endocarditis even with negative urinary findings.
- Atypical presentations challenge diagnostic pathways for infective endocarditis.
- Prompt antibiotic treatment can lead to favorable outcomes, potentially avoiding prolonged interventions like hemodialysis.
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