Tricuspid valve endocarditis caused by Campylobacter fetus bacteremia in a 48-year old female – a case report

Background Campylobacter infections are very common overall. They usually affect the gastrointestinal tract and are caused by contaminated meat or water. Older people, men, and people with weakened immune systems are significantly more likely to be affected. Endocarditis caused by C. fetus, especially of the tricuspid valve, is rarely reported and not easily to diagnose. Case Summary A 48-year-old female patient presented to emergency department with pain in the upper abdomen, in the left flank, and tenderness in the left chest. After initially ruling out pyelonephritis, within the scope of focus search, vegetation on the tricuspid valve with rapidly progressive tricuspid valve insufficiency was observed. Campylobacter fetus grew in the initial blood cultures., antibiotic treatment was initiated with ceftriaxone. Due to additional unclear renal insufficiency and further treatment, the patient was transferred to an interdisciplinary center, where tricuspid valve replacement was performed. The patient was discharged home with a peripherally inserted central catheter for prolonged intravenous antibiotic therapy with meropenem. Discussion Diagnosis was difficult based on the variety of symptoms, as the patient had not typical symptoms of an endocarditis and was a younger female. Follow-up examinations and consultation with an interdisciplinary center were necessary to ensure adequate treatment. The patient initially received intravenous cephalosporin, aminopenicillin, and finally carbapenem antibiotics. Due to a lack of recommendations, antibiotic therapy was based on empirical evidence. Amoxicillin-clavulanic acid and imipenem have been described as effective antibiotics against almost all strains of C. fetus.