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A Cerebrovascular Accident in the Setting of Kingella kingae Infective Endocarditis: A Case Report

Aneil S Walizada1, Arianna Lozada1, Dania Rizwan1

  • 1Internal Medicine, Hospital Corporation of America (HCA) Florida Westside Hospital, Plantation, USA.

Cureus
|August 27, 2025
PubMed

Insights

Kingella kingae endocarditis is rare but increasingly detected with advanced diagnostics. Early identification enabled conservative management for an immunocompromised patient with cerebral infarctions.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Neurology

Background:

  • Kingella kingae is a rare cause of infective endocarditis (IE), particularly in adults.
  • The HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella) group comprises fastidious Gram-negative bacteria.
  • Advances in molecular diagnostics have improved the identification of atypical pathogens like K. kingae.

Observation:

  • A 78-year-old immunocompromised woman presented with fever, altered mental status, and right-sided weakness.
  • She was diagnosed with K. kingae bacteremia and infective endocarditis with a 7 mm aortic valve vegetation.
  • The patient also developed watershed territory cerebral infarctions secondary to the endocarditis.

Findings:

  • Polymerase chain reaction (PCR) and MALDI-TOF MS facilitated the early and accurate identification of K. kingae.
  • Despite the severity of her presentation, the patient was managed conservatively with long-term intravenous antibiotics due to high surgical risk.
  • This approach highlights the feasibility of non-surgical management in select cases.

Implications:

  • Early detection of K. kingae through modern diagnostic tools is crucial for timely intervention.
  • Conservative management with antibiotics can be a viable option for K. kingae endocarditis in high-risk patients.
  • This case underscores the evolving diagnostic capabilities and treatment strategies for uncommon causes of IE.

Keywords:
cerebrovascular accidenthacekinfective endocarditiskingella kingaeseptic emboli

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