Aerococcus urinae, a rare cause of infective endocarditis. (20th July 2016)

• Record Type: Journal Article
• Authors: Melnick, Stephen; Nazir, Salik; Hingorani, Rittu; Wexler, Philip
• Is Part Of: BMJ case reports. Volume 2016
• Publication Date: 2016-07-20
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2016-215421
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We present the case of an elderly male who was initially seen in our hospital for a urinary tract infection that was treated with oral ciprofloxacin. He was admitted 2 weeks later with altered mental status and fever, and was found to have bacteraemia with Aerococcus urinae . Owing to altered mental status a brain MRI was performed which showed evidence of embolic stroke. Following this, a transesophageal echocardiogram showed severe mitral regurgitation and a vegetation >1 cm involving the mitral valve with associated destruction of posterior valve leaflets. The patient was started on antibiotics intravenous penicillin G and intravenous gentamicin for a total duration of 6 weeks. He underwent mitral valve replacement on day 4 of hospitalisation. The postoperative course was complicated by ventilator-dependent respiratory failure, requiring tracheostomy and eventual transfer to a skilled nursing facility. Unfortunately, he died after 2 weeks of stay at the facility.