Staphylococcus saprophyticus Endocarditis Possibly Originating from a Rectal Ulcer Diagnosed after Recurrent Ischemic...

Staphylococcus saprophyticus primarily colonizes the lower gastrointestinal tract; however, infections from this site are rarely reported. A 77-year-old man developed an ischemic stroke and fever. Blood cultures showed S. saprophyticus, but repeated transthoracic echocardiography showed no vegetation. The patient was discharged after two weeks of antibiotic treatment. Four months later, the patient was readmitted with recurrent fever and stroke, and transesophageal echocardiography confirmed infective endocarditis (IE). No urinary or catheter-related entry was identified; however, a rectal ulcer was detected. This case highlights the potential of S. saprophyticus, a low-virulence bacterium, to cause IE with significant morbidity, and suggests gastrointestinal mucosal disruption as an entry site.