Key result
Combined medical-surgical treatment resolves complex endocarditis, yielding a ~31-point LVEF improvement at 3 years.
Why the study?
Enterobacter cloacae infective endocarditis carries high mortality, partly due to antimicrobial resistance and limited clinical experience.
Case Report (n=1)
No
This case report highlights that successful management of rare, high-mortality Enterobacter cloacae infective endocarditis in a patient with pre-existing valvular disease requires a multidisciplinary approach combining source control (dental extraction), prolonged targeted combination antimicrobial therapy, and timely surgical intervention (Bentall procedure and mitral valve repair).
Answers are grounded in this paper and cite their sources.
May support multidisciplinary management in rare Enterobacter endocarditis; leaves open need for prospective data on optimal regimens.
Infective endocarditis remains a potentially lethal disease with varied presentations. Enterobacter cloacae endocarditis has high mortality, partly due to antimicrobial resistance and limited clinical experience. We report a 57-year-old male with chronic heart failure and double aortic lesion, admitted with acute heart failure. Blood cultures were positive for E. cloacae. Despite antibiotics, fever spikes recurred, correlating with dental defocalization evaluations. Echocardiography revealed mitral valve vegetation. Dental necrosis and periodontitis were diagnosed. The patient received a 6-week antibiotic regimen and underwent dental treatment and Bentall surgery. After 3 years, clinical evolution was favorable. The case underscores the complexity of managing E. cloacae endocarditis, emphasizing the importance of timely antibiotics and surgical intervention.
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Cortez-Sandoval et al. (2024) conducted a case report in Enterobacter cloacae infective endocarditis with pre-existing valvular heart disease and periodontal disease (n=1). Combined antibiotic therapy (meropenem, amikacin, cefepime, clindamycin), dental extraction, Bentall procedure, and mitral valve repair was evaluated on Clinical evolution and left ventricular ejection fraction (LVEF) at 3-year follow-up.
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