[Bacterial endocarditis due to Staphylococcus epidermidis. Two cases (author's transl)].

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Context:

• Bacterial endocarditis caused by Staphylococcus epidermidis is infrequently encountered but associated with significant morbidity.
• Prosthetic valve endocarditis presents unique challenges in diagnosis and management.
• Co-existing conditions, such as liver disease and corticosteroid use, can influence patient susceptibility and treatment outcomes.

Purpose:

• To report two rare cases of bacterial endocarditis caused by Staphylococcus epidermidis.
• To describe the clinical presentation, treatment strategies, and outcomes in patients with Staphylococcus epidermidis endocarditis.
• To highlight the complexities in managing prosthetic valve endocarditis.

Summary:

• The first case involved a 58-year-old male with a double prosthetic valve (mitral and aortic) who developed endocarditis 40 days post-surgery. Treatment with vancomycin and gentamicin, followed by pristinamycin and tobramycin, achieved a cure.
• The second case concerned a 50-year-old female with cirrhogenic hepatitis and on corticosteroids, who developed endocarditis without an identifiable source. Despite various antibiotic combinations, surgical intervention with mitral Starr valve replacement was necessary for cure.
• Neither patient exhibited signs of valvular damage or prosthesis dislodgement.

Impact:

• This case series underscores the importance of considering Staphylococcus epidermidis in prosthetic valve endocarditis, even in rare instances.
• It demonstrates the potential efficacy of specific antibiotic combinations and the critical role of surgical intervention in refractory cases.
• The findings contribute to the understanding of managing severe endocarditis in complex patient populations.