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Case Report: Rare Case of Staphylococcus pasteuri Endocarditis
Esben Merrild1, Mette Winther2, Jonathan Nørtoft Dahl3,4
1Department of Medicine, Randers Regional Hospital, Randers, Denmark.
Case Reports in Cardiology
|April 4, 2023
Summary
A patient with a history of Staphylococcus aureus endocarditis experienced complications including popliteal artery thrombosis and embolic brain lesions. Despite initial treatment, aortic root fistulation led to fatal cardiogenic shock.
Area of Science:
- Cardiology
- Infectious Diseases
- Neurology
Background:
- A 45-year-old woman with a history of Staphylococcus aureus endocarditis, biological aortic valve replacement, and intravenous drug abuse presented with severe right leg pain and dyspnea.
- Her medical history indicated significant risk factors for recurrent infections and cardiovascular complications.
Observation:
- The patient presented with fever, elevated infectious markers, and troponin levels.
- Initial investigations revealed thrombosis of the right popliteal artery and an excrescence on the biological aortic valve.
- Neurological symptoms, including aphasia and limb weakness, developed, later confirmed as micro-embolic brain lesions.
Findings:
- Blood cultures identified Staphylococcus pasteuri as the causative agent.
- Despite antibiotic treatment and anticoagulation, the patient developed aortic root fistulation to the left atrium.
- The patient experienced cardiogenic shock and ultimately died.
Implications:
- This case highlights the complex management of recurrent infective endocarditis in patients with prosthetic valves and comorbidities.
- It underscores the risk of embolic events and devastating complications like aortic root fistulation.
- Optimal treatment strategies for such high-risk patients require careful consideration of surgical candidacy and long-term outcomes.
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