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Staphylococcus saprophyticus Endocarditis Possibly Originating from a Rectal Ulcer Diagnosed after Recurrent Ischemic
Naoki Tani1,2, Shuji Yoshino1, Tatsuya Mukai3
1Department of Infectious Diseases, Fukuoka City Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|September 10, 2025
Summary
Staphylococcus saprophyticus, typically found in the gut, can cause serious heart infections like infective endocarditis (IE). This case suggests gastrointestinal issues may be an entry point for this rare but serious condition.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Staphylococcus saprophyticus commonly colonizes the lower gastrointestinal tract.
- Infections originating from the gastrointestinal tract, particularly infective endocarditis (IE), are infrequently reported for this bacterium.
- The bacterium is generally considered to have low virulence.
Purpose of the Study:
- To report a rare case of infective endocarditis caused by Staphylococcus saprophyticus.
- To investigate the potential gastrointestinal origin of Staphylococcus saprophyticus infective endocarditis.
- To highlight the clinical significance and potential morbidity associated with Staphylococcus saprophyticus IE.
Main Methods:
- Case report of a 77-year-old male patient with recurrent fever and stroke.
- Blood cultures for bacterial identification.
- Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) for vegetation detection.
- Clinical examination to identify potential infection entry sites.
Main Results:
- Blood cultures identified Staphylococcus saprophyticus in a patient presenting with fever and ischemic stroke.
- Initial TTE did not reveal vegetations; however, TEE performed during readmission confirmed infective endocarditis.
- No urinary or catheter-related source was identified; a rectal ulcer was found as a potential gastrointestinal entry site.
- The patient experienced recurrent stroke and fever despite initial antibiotic treatment.
Conclusions:
- Staphylococcus saprophyticus can cause severe infective endocarditis, even in the absence of typical risk factors.
- Gastrointestinal mucosal disruption, such as a rectal ulcer, may serve as an entry point for Staphylococcus saprophyticus to cause bloodstream infections and IE.
- This case underscores the importance of considering less common bacterial sources and gastrointestinal pathology in the diagnosis of infective endocarditis.
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