Gram-negative bacteria causing infective endocarditis: Rare cardiac complication after liver transplantation

Abstract

Bacterial endocarditis is a rare complication amongst solid organ transplant recipients and is often linked to bacteremia. Majority of these recipients do not have underlying valvular heart disease or congenital valvular abnormalities. Staphylococoocusaureus and Enterococcus species are the most commonly isolated organisms. There are very few reports of gram-negative bacteria causing endocarditis in liver transplant recipients. We report a 51-yearold male, a liver transplant recipient, who developed bacterial endocarditis of the mitral valve due to extended spectrum of betalactamase producing strain of Escherichia coli and was managed successfully with antibiotics. Key words: Bacteria; Infective endocarditis; Liver transplantationCore tip: A pre-transplant cardiac assessment should include a careful evaluation for underlying valvular pathology. Bacterial endocarditis can however still occur in liver transplant recipients with normal cardiac valves. Gram negative bacteria though rare can be a causative agent for infective endocarditis. High index of suspicion for bacterial endocarditis is essential when investigating transplant recipients for fever of uncertain origin.George S, Varghese J, Chandrasekhar S, Perumalla R, Reddy MS, Jayanthi V, Rela M. Gram-negative bacteria causing infective endocarditis: Rare cardiac complication after liver transplantation. World J Hepatol 2013; 5(5): 296-297 Available from: URL:

High Mortality and Graft Loss After Infective Endocarditis in Kidney Transplant Recipients: A Case-Controlled Study From Two Centers

“…In that respect the epidemiology in our study is closer to that of the general population [1]. We found that digestive bacteria predominate, with Enterococci as the most frequent pathogen as previously described in SOTRs [15][16][17][18][19][20][21]14,21]. A hypothetical mechanism, in the absence of an identified digestive gateway (colonoscopy was performed in most of the cases where a digestive bacterium was identified, even though we did not collect the results of this exam in our study), could be the alteration of the gut microbiota by the combination of antibiotic treatment frequently used after transplantation, and of immunosuppressive drugs.…”

Endocarditis in Liver Transplant Recipients: A Systematic Review

“…Additionally, two studies were included after reference search of the abovementioned studies. Finally, 39 studies met the present study’s inclusion criteria [ 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. Additional information was kindly provided by the corresponding authors of two studies [ 40 , 48 ].…”

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

“…George et al 10 reported a similar case of ESBL producing E. coli endocarditis, which was treated successfully with parenteral meropenem and tigecycline for 6 weeks. However, the patient in question did have a source of bacteraemia in the form of a recent urinary infection, had received unspecified antibiotics and had been in hospital and an intensive care unit prior to developing endocarditis.…”