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Four-valve polymicrobial endocarditis caused by Pseudomonas aeruginosa and Serratia marcescens

Insights

This case report details the first instance of mixed Pseudomonas and Serratia endocarditis affecting all four heart valves in a nonaddicted patient. The infection, likely hospital-acquired, presented clinically as right-sided endocarditis.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Endocarditis is an infection of the heart lining or valves.
  • Mixed bacterial infections are rare but serious causes of endocarditis.
  • Pseudomonas and Serratia are opportunistic pathogens that can cause severe infections.

Observation:

  • A 56-year-old nonaddicted patient developed endocarditis involving all four heart valves.
  • Cultures identified both Pseudomonas and Serratia species.
  • Light and electron microscopy confirmed tissue invasion by both organisms.

Findings:

  • This is the first reported case of mixed Pseudomonas and Serratia endocarditis with four-valve involvement.
  • The probable cause was nosocomial (hospital-acquired) infection.
  • Clinical presentation mimicked right-sided endocarditis, despite multi-valve and multi-organism involvement.

Implications:

  • Highlights the potential for rare, severe endocarditis in non-traditional patient populations.
  • Emphasizes the importance of considering polymicrobial infections in complex cases.
  • Suggests that clinical presentation may not always reflect the full extent of valvular or microbial involvement.

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