Skip to main content
Top
Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Escherichia Coli | Case report

Importance of early diagnosis and surgical treatment of calcified amorphous tumor-related native valve endocarditis caused by Escherichia coli: a case report

Authors: Shu Koito, Yuto Unoki, Keimei Yoshida, Sho Takemoto, Takayuki Uchida, Takashi Matono

Published in: BMC Infectious Diseases | Issue 1/2022

Login to get access

Abstract

Background

Unlike Escherichia coli bacteremia, which is common, E. coli endocarditis is uncommon, particularly in patients with native valve, leading to its delayed diagnosis.

Case presentation

We present a case of infective endocarditis caused by E. coli in a 78-year-old Japanese man with type 2 diabetes, involving persistent bacteremia and vegetation on the mitral valve (measuring 18 × 4.2 mm in diameter). He presented with recurrent fever after antimicrobial treatment for pyelonephritis. He received antibiotic therapy for 6 weeks and required surgical removal of a calcified amorphous tumor and vegetation with mitral valvuloplasty 7 days after admission. Despite an episode of multiple cerebral infarctions, he recovered fully from the infection.

Conclusions

Follow-up blood cultures should be performed for Gram-negative bacilli bacteremia among patients with unknown focus and an atypical clinical course after treatment. Early diagnosis and aggressive surgical intervention are paramount to achieving good clinical outcomes.
Literature
1.
go back to reference Fisman D, Patrozou E, Carmeli Y, Perencevich E, Tuite AR, Mermel LA, et al. Geographical variability in the likelihood of bloodstream infections due to gram-negative bacteria: correlation with proximity to the equator and health care expenditure. PLoS ONE. 2014;9: e114548.CrossRef Fisman D, Patrozou E, Carmeli Y, Perencevich E, Tuite AR, Mermel LA, et al. Geographical variability in the likelihood of bloodstream infections due to gram-negative bacteria: correlation with proximity to the equator and health care expenditure. PLoS ONE. 2014;9: e114548.CrossRef
2.
go back to reference Shorr AF, Tabak YP, Killian AD, Gupta V, Liu LZ, Kollef MH. Healthcare-associated bloodstream infection: a distinct entity? insights from a large US database. Crit Care Med. 2006;34:2588–95.CrossRef Shorr AF, Tabak YP, Killian AD, Gupta V, Liu LZ, Kollef MH. Healthcare-associated bloodstream infection: a distinct entity? insights from a large US database. Crit Care Med. 2006;34:2588–95.CrossRef
3.
go back to reference Morpeth S, Murdoch D, Cabell CH, Karchmer AW, Pappas P, Levine D, et al. Non-HACEK gram-negative bacillus endocarditis. Ann Intern Med. 2007;147:829–35.CrossRef Morpeth S, Murdoch D, Cabell CH, Karchmer AW, Pappas P, Levine D, et al. Non-HACEK gram-negative bacillus endocarditis. Ann Intern Med. 2007;147:829–35.CrossRef
4.
go back to reference Falcone M, Tiseo G, Durante-Mangoni E, Ravasio V, Barbaro F, Ursi MP, et al. Risk factors and outcomes of endocarditis due to non-HACEK Gram-negative bacilli: data from the prospective multicenter Italian endocarditis study cohort. Antimicrob Agents Chemother. 2018;62:e02208-e2217.CrossRef Falcone M, Tiseo G, Durante-Mangoni E, Ravasio V, Barbaro F, Ursi MP, et al. Risk factors and outcomes of endocarditis due to non-HACEK Gram-negative bacilli: data from the prospective multicenter Italian endocarditis study cohort. Antimicrob Agents Chemother. 2018;62:e02208-e2217.CrossRef
5.
go back to reference Chambers HF, Bayer AS. Native-valve infective endocarditis. N Engl J Med. 2020;383:567–76.CrossRef Chambers HF, Bayer AS. Native-valve infective endocarditis. N Engl J Med. 2020;383:567–76.CrossRef
6.
go back to reference Raza SS, Sultan OW, Sohail MR. Gram-negative bacterial endocarditis in adults: state-of-the-heart. Expert Rev Anti Infect Therapy. 2010;8:879–85.CrossRef Raza SS, Sultan OW, Sohail MR. Gram-negative bacterial endocarditis in adults: state-of-the-heart. Expert Rev Anti Infect Therapy. 2010;8:879–85.CrossRef
7.
go back to reference Gransden WR, Eykyn SJ, Phillips I, Rowe B. Bacteremia due to Escherichia coli: a study of 861 episodes. Rev Infect Dis. 1990;12:1008–18.CrossRef Gransden WR, Eykyn SJ, Phillips I, Rowe B. Bacteremia due to Escherichia coli: a study of 861 episodes. Rev Infect Dis. 1990;12:1008–18.CrossRef
8.
go back to reference Ani C, Farshidpanah S, Bellinghausen Stewart A, Nguyen HB. Variations in organism-specific severe sepsis mortality in the United States: 1999–2008. Crit Care Med. 2015;43:65–77.CrossRef Ani C, Farshidpanah S, Bellinghausen Stewart A, Nguyen HB. Variations in organism-specific severe sepsis mortality in the United States: 1999–2008. Crit Care Med. 2015;43:65–77.CrossRef
9.
go back to reference Prendergast BD. The changing face of infective endocarditis. Heart. 2006;92:879–85.CrossRef Prendergast BD. The changing face of infective endocarditis. Heart. 2006;92:879–85.CrossRef
10.
go back to reference Micol R, Lortholary O, Jaureguy F, Bonacorsi S, Bingen E, Lefort A, et al. Escherichia coli native valve endocarditis. Clin Microbiol Infect. 2006;12:401–3.CrossRef Micol R, Lortholary O, Jaureguy F, Bonacorsi S, Bingen E, Lefort A, et al. Escherichia coli native valve endocarditis. Clin Microbiol Infect. 2006;12:401–3.CrossRef
11.
go back to reference Mushtaq A, Bredell BX, Soubani AO. Repeating blood cultures after initial bacteremia: when and how often? Cleve Clin J Med. 2019;86:89–92.CrossRef Mushtaq A, Bredell BX, Soubani AO. Repeating blood cultures after initial bacteremia: when and how often? Cleve Clin J Med. 2019;86:89–92.CrossRef
12.
go back to reference Baddour LM, Wilson WR, Bayer AS, Fowler VG, Tleyjeh IM, Rybak MJ, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015;132:1435–86.CrossRef Baddour LM, Wilson WR, Bayer AS, Fowler VG, Tleyjeh IM, Rybak MJ, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015;132:1435–86.CrossRef
13.
go back to reference Canzoneri CN, Akhavan BJ, Tosur Z, Andrade PEA, Aisenberg GM. Follow-up blood cultures in Gram-negative bacteremia: are they needed? Clin Infect Dis. 2017;65:1776–9.CrossRef Canzoneri CN, Akhavan BJ, Tosur Z, Andrade PEA, Aisenberg GM. Follow-up blood cultures in Gram-negative bacteremia: are they needed? Clin Infect Dis. 2017;65:1776–9.CrossRef
14.
go back to reference Habib G, Badano L, Tribouilloy C, Vilacosta I, Zamorano JL, Galderisi M, et al. Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr. 2010;11:202–19.CrossRef Habib G, Badano L, Tribouilloy C, Vilacosta I, Zamorano JL, Galderisi M, et al. Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr. 2010;11:202–19.CrossRef
15.
go back to reference Mügge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach. J Am Coll Cardiol. 1989;14:631–8.CrossRef Mügge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach. J Am Coll Cardiol. 1989;14:631–8.CrossRef
16.
go back to reference Carlo V, Pompilio F. Cardiology Area: an essential instrument for the Italian Association of Cardiac Prevention and Rehabilitation (GICR-IACPR). Monaldi Arch Chest Dis. 2020;90:1359. Carlo V, Pompilio F. Cardiology Area: an essential instrument for the Italian Association of Cardiac Prevention and Rehabilitation (GICR-IACPR). Monaldi Arch Chest Dis. 2020;90:1359.
17.
go back to reference Tsutsumi T, Hiraoka E, Kanazawa K, Akita H, Eron LJ. Diagnosis of E. coli tricuspid valve endocarditis: a case report. Hawaii Med J. 2010;69:286–8.PubMedPubMedCentral Tsutsumi T, Hiraoka E, Kanazawa K, Akita H, Eron LJ. Diagnosis of E. coli tricuspid valve endocarditis: a case report. Hawaii Med J. 2010;69:286–8.PubMedPubMedCentral
18.
go back to reference Bishara J, Leibovici L, Gartman-Israel D, Sagie A, Kazakov A, Miroshnik E, et al. Long-term outcome of infective endocarditis: the impact of early surgical intervention. Clin Infect Dis. 2001;33:1636–43.CrossRef Bishara J, Leibovici L, Gartman-Israel D, Sagie A, Kazakov A, Miroshnik E, et al. Long-term outcome of infective endocarditis: the impact of early surgical intervention. Clin Infect Dis. 2001;33:1636–43.CrossRef
19.
go back to reference Reynolds C, Tazelaar HD, Edwards WD. Calcified amorphous tumor of the heart (cardiac CAT). Hum Pathol. 1997;28:601–6.CrossRef Reynolds C, Tazelaar HD, Edwards WD. Calcified amorphous tumor of the heart (cardiac CAT). Hum Pathol. 1997;28:601–6.CrossRef
20.
go back to reference Greaney L, Chaubey S, Pomplun S, St Joseph E, Monaghan M, Wendler O. Calcified amorphous tumour of the heart: presentation of a rare case operated using minimal access cardiac surgery. BMJ Case Rep. 2011;2011:bcr0220113882.CrossRef Greaney L, Chaubey S, Pomplun S, St Joseph E, Monaghan M, Wendler O. Calcified amorphous tumour of the heart: presentation of a rare case operated using minimal access cardiac surgery. BMJ Case Rep. 2011;2011:bcr0220113882.CrossRef
21.
go back to reference Russo TA, Johnson JR. Proposal for a new inclusive designation for extraintestinal pathogenic isolates of Escherichia coli: ExPEC. J Infect Dis. 2000;181:1753–4.CrossRef Russo TA, Johnson JR. Proposal for a new inclusive designation for extraintestinal pathogenic isolates of Escherichia coli: ExPEC. J Infect Dis. 2000;181:1753–4.CrossRef
Metadata
Title
Importance of early diagnosis and surgical treatment of calcified amorphous tumor-related native valve endocarditis caused by Escherichia coli: a case report
Authors
Shu Koito
Yuto Unoki
Keimei Yoshida
Sho Takemoto
Takayuki Uchida
Takashi Matono
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07220-w

Other articles of this Issue 1/2022

BMC Infectious Diseases 1/2022 Go to the issue