A case of prosthetic valve endocarditis and aortic abscess due to Bacillus cereus

Akina Fukushima; Takaaki Kobayashi; Yoshihito Otsuka; Naoto Hosokawa; Sandra Moody; Miyu Takagi; Akihito Yoshida

doi:10.1016/j.idcr.2024.e01940

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A case of prosthetic valve endocarditis and aortic abscess due to Bacillus cereus

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A case of prosthetic valve endocarditis and aortic abscess due to Bacillus cereus

Akina Fukushima, Takaaki Kobayashi, Yoshihito Otsuka, Naoto Hosokawa, Sandra Moody, Miyu Takagi and Akihito Yoshida

IDCases, Vol.36, e01940

2024

DOI: 10.1016/j.idcr.2024.e01940

PMCID: PMC11046206

PMID: 38681080

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Abstract

Bacillus cereus (B. cereus) is commonly found in the environment and is often considered a blood culture contaminant. However, in patients with specific risk factors such as intravenous drug use, central venous access catheters, immunosuppression, or prosthetic valves, B. cereus can cause severe infections. Herein, we present a case of prosthetic valve endocarditis (PVE) caused by B. cereus in an 84-year-old woman with a history of aortic valve replacement for aortic stenosis five years earlier. She presented with anorexia, and her physical examination revealed tenderness in the left upper quadrant of the abdomen. Blood culture grew B. cereus, and a CT scan showed splenic infarction, raising suspicion of PVE. Transesophageal echocardiogram (TEE) revealed an abscess around the left coronary cusp of the aortic valve and a 15 mm vegetation. Due to the patient's high risk for post-operative complications and her unwillingness to undergo surgery, the surgery was deferred. Instead, she was successfully treated with six weeks of intravenous vancomycin and discharged home. Follow-up TEE demonstrated resolution of the vegetation and valvular abscess. At her six-month post-discharge evaluation, no signs of active infection were noted including fever or worsening heart failure. Although surgery is typically recommended for most cases of PVE, conservative treatment can be considered as an alternative option for selected patients.

Bacillus cereus

Prosthetic valve endocarditis

Details

Title: Subtitle: A case of prosthetic valve endocarditis and aortic abscess due to Bacillus cereus
Creators: Akina Fukushima - Kameda Medical Center
Takaaki Kobayashi - University of Iowa
Yoshihito Otsuka - Kameda Medical Center
Naoto Hosokawa - Kameda Medical Center
Sandra Moody - University of California, San Francisco
Miyu Takagi - Kameda Medical Center
Akihito Yoshida - Kameda Medical Center
Resource Type: Journal article
Publication Details: IDCases, Vol.36, e01940
Publisher: Elsevier Ltd
DOI: 10.1016/j.idcr.2024.e01940
PMID: 38681080
PMCID: PMC11046206
ISSN: 2214-2509
eISSN: 2214-2509
Language: English
Date published: 2024
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9984618624802771

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