[Serratia marcescens prosthetic mitral valve endocarditis associated with hemolytic anemia]

A 57-year-old female who had been performed mitral valve replacement (MVR) using 31 mm prosthetic valve 32 months before entered the hospital for the evaluation of long standing severe hemolytic anemia without infectious sign. Transesophageal echocardiogram revealed a moderate sized vegetation on the atrial site of the prosthetic valve. The size and number of the vegetation were increased after deterioration of infectious illness. Blood culture grew serratia marcessans and alpha-hemolytic Streptococcus. Re-MVR was carried out with the diagnosis of prosthetic valve endocarditis (PVE). As the symptom of PVE, hemolytic anemia without infectious sign is a rare condition. TEE is an useful method to make diagnosis of PVE by detecting the vegetations and evaluating their change of size and methods and to evaluate the effectiveness of the treatment.