Aeromonas Endocarditis in an Intravenous Drug User Patient with Human Immunodeficiency Virus and Hepatitis C Virus Co-infection: A Case Report

Introduction: We report on a 39-year-old Taiwan male, who was an intravenous drug user with human immunodeficiency virus and hepatitis C virus co-infection for 7 years, did not harbor any opportunistic infections, and had been receiving Highly Active Anti-retroviral Therapy for two months; and he suffering from jaundice, fatigue and fever for two months. Chest radiography revealed bilateral infiltration and acute pulmonary edema. Transthoracic echocardiography revealed a vegetation located on the tricuspid leaflets, suspected infective endocarditis. The diagnosis was confirmed of infective endocarditis by detecting Aeromona hydrophila in two sets of blood cultures. He received initially intravenous meropenem empiric treatment. An unexpected death occurred because of cardiac arrhythmia with polymorphic ventricular tachycardia.Conclusion: The case suggests that infective endocarditis should be considered as presenting with sepsis related to cardiac involvement relevant to unusual microorganisms, Aeromona hydrophila, infection in individuals of HIV-infected, chronic liver diseases, or intravenous user.