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A Rare Case of Quadrivalvular Infective Endocarditis
Mahidhar Jeedigunta1, Padmakumar R1, Krishnananda2
1Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Case Reports in Medicine
|September 2, 2025
Summary
Quadrivalvular infective endocarditis, affecting all four heart valves, is exceptionally rare, especially when caused by Granulicatella. This case highlights a unique instance and emphasizes prompt diagnosis and treatment for better outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Microbiology
Background:
- Infective endocarditis (IE) is a severe infection with high mortality.
- Quadrivalvular IE, involving all four heart valves, is exceedingly rare.
- Nutritionally variant streptococci, such as Granulicatella, are uncommon causes of IE.
Observation:
- A rare case of quadrivalvular IE caused by Granulicatella adiacens in a female patient with a ventricular septal defect.
- The patient presented with fever, congestive heart failure, anemia, glomerulonephritis, and abdominal pain.
- Vegetations were observed on all four heart valves (pulmonary, tricuspid, mitral, aortic) with associated regurgitation.
Findings:
- Blood cultures confirmed Granulicatella adiacens as the causative agent.
- The patient showed clinical improvement with antibiotics, decongestive therapy, and blood transfusion.
- Quadrivalvular IE due to Granulicatella has not been previously documented.
Implications:
- This case underscores the importance of considering rare pathogens in complex IE cases.
- Congenital heart disease can predispose individuals to infective endocarditis.
- Timely diagnosis and treatment are crucial for managing severe cases of infective endocarditis.
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