Staphylococcus caprae , a non‐ aureus staphylococcus primarily associated with goats, is typically regarded as a commensal organism. While its role in veterinary contexts is well established, its emergence as a human pathogen in healthcare settings has gained increasing recognition. It has been implicated in infections such as bacteremia, otitis externa, osteoarticular infections, and prosthetic device–related complications. However, infective endocarditis caused by S. caprae remains extremely rare, with only six cases reported in the literature since 1995. This report presents a case of native valve infective endocarditis due to methicillin‐resistant S. caprae in a previously healthy 40‐year‐old male with no history of animal contact. The patient presented with fever, dyspnea, and signs of heart failure. Echocardiographic evaluation revealed vegetations on both the aortic and mitral valves, and blood cultures confirmed the presence of S. caprae . Initial empirical therapy with ceftriaxone and vancomycin was started and later adjusted to linezolid based on antimicrobial susceptibility testing. Despite appropriate antimicrobial treatment and intensive supportive care, the patient’s condition progressively deteriorated. He experienced neurological decline, hemodynamic instability, and ultimately died following cardiac arrest before surgical intervention could be performed. This case highlights the diagnostic challenges in identifying S. caprae , as conventional phenotypic methods often misclassify the organism. Advanced techniques such as MALDI‐TOF MS provide more accurate identification. Antimicrobial susceptibility testing is essential, as treatment options may vary. Fosfomycin resistance may serve as a presumptive marker for S. caprae , though cross‐resistance with other species limits its specificity. Given the rarity of S. caprae endocarditis, clinicians should maintain awareness of its potential occurrence, even in patients without animal exposure but with healthcare‐associated risks. Early microbiological diagnosis, targeted antibiotic therapy, and prompt surgical evaluation are crucial for managing this uncommon and clinically significant infection.
Alcala-Gonzalez et al. (Thu,) studied this question.