Community-acquired multidrug-resistant Gram-negative bacterial infective endocarditis

Naha, Sowjanya; Naha, Kushal; Acharya, Vasudev; Hande, Manjunath; Vivek, G

doi:10.1136/bcr-2014-204176

Cited by 3 publications

(1 citation statement)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, based on phenotypic resistance analysis using Advanced Expert System VITEK 2 Software, we concluded that this is an ESBL production isolate, which is resistant to a variety of b-lactamase inhibitors. This emergence of multidrugresistant Escherichia coli is increasingly reported as the etiology of various infections, including IE [21][22][23]. Study from Ebbing, et al found that ESBL-producing Escherichia coli infection was associated with significantly longer hospital stay duration and greater hospital charges [24].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Vasculitis and Generalized Lymphadenopathy Associated with Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli Endocarditis: A Rare Case Report

et al. 2020

View full text Add to dashboard Cite

Introduction Infective endocarditis (IE) has been known as the great imitator due to variable clinical manifestation, making its diagnosis challenging. A missed diagnosis could lead to inappropriate therapy. We presented a rare case of blood culture-negative infective endocarditis (BCNIE) due to extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli manifest with cutaneous vasculitis and generalized lymphadenopathy. We highlighted its diagnostic challenge and management. Case Illustration and Discussion A 36-year-old male with known asymptomatic ruptured sinus of Valsalva (SOV) presented with fever of unknown origin for six months, fatigue, weight loss with a history of multiple hospitalizations. The physical examination revealed a continuous murmur at Erb's point, cutaneous vasculitis, and bilateral inguinal lymphadenopathy. The laboratory result was leukocytosis and elevated C-Reactive Protein (CRP). Generalized lymphadenopathy was detected from the thorax and abdominal Computed Tomography (CT) Scans. Positive Anti Nuclear Antibody (ANA) Indirect Immunofluorescence (IF) speckled pattern led us to consider an autoimmune as the etiology, but we still considered IE as a differential diagnosis due to history of structural heart disease. Detection of multiple tiny oscillating masses at the tricuspid valve from the echocardiogram and cardiac CT led to possible IE diagnosis. Negative three consecutive blood cultures led the diagnosis to BCNIE. Surgery was performed to evacuate the vegetations, repair the SOV, and tricuspid valve replacement with a bioprosthetic valve. These results in improvement of the patient’s condition. ESBL-producing Escherichia coli yielded in tissue culture made the diagnosis of IE became definite. Conclusion ESBL-producing Escherichia coli should be considered as the etiology of BCNIE. Cutaneous vasculitis and generalized lymphadenopathy as a manifestation of IE could lead to diagnostic confusion. A thorough investigation will help clinician to avoid delay or inappropriate treatment that could be detrimental for the patient.

show abstract

Section: Discussionmentioning

confidence: 99%

Cutaneous Vasculitis and Generalized Lymphadenopathy Associated with Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli Endocarditis: A Rare Case Report

et al. 2020

View full text Add to dashboard Cite

show abstract

Perspectives on the History of Endocarditis

Ronald¹

2016

Endocarditis

View full text Add to dashboard Cite

Escherichia coli Urosepsis Leading to Native Valve Endocarditis

Sagar

Kamat

Akhil

et al. 2022

Journal of the Practice of Cardiovascular Sciences

View full text Add to dashboard Cite

Escherichia coli, a Gram-negative facultative anaerobe, is the common causative organism leading to urinary tract infection. However, the involvement of endocardium byE. colihas been reported to be very rare in spite of the septicemia caused by this organism. However, the mortality rate due to infective endocarditis caused byE. coliwas reported to be higher than due to other organisms like HACEK group of organisms. Conventional risk factors leading to infective endocarditis include cirrhosis of the liver, prosthetic heart valves, and other sources of infection like urosepsis. Here, we report the case of a 60-year-old diabetic male who presented with obstructive uropathy-induced urinary tract infection leading to infective endocarditis.

show abstract

Community-acquired multidrug-resistant Gram-negative bacterial infective endocarditis

Cited by 3 publications

References 14 publications

Cutaneous Vasculitis and Generalized Lymphadenopathy Associated with Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli Endocarditis: A Rare Case Report

Cutaneous Vasculitis and Generalized Lymphadenopathy Associated with Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli Endocarditis: A Rare Case Report

Perspectives on the History of Endocarditis

Escherichia coli Urosepsis Leading to Native Valve Endocarditis

Contact Info

Product

Resources

About