Aerococcus Urinae Endocarditis: A Case Report and Literature Review

Abstract

A 75-year-old male, with a past medical history of chronic kidney disease stage 3 (CKD3) and a recent diagnosis of bilateral hydronephrosis and Foley catheter placement, presented to the emergency department for fever. Blood cultures grew Aerococcus urinae. Transthoracic echo (TTE) demonstrated thickened aortic valve leaflets with perforation, multiple echo densities, and severe aortic regurgitation. The patient developed decompensated congestive heart failure and cardiogenic shock. En route to surgery for emergent aortic valve replacement, the patient lost pulse and was resuscitated. The patient was subsequently transferred to the ICU where the family decided to initiate comfort care measures. This case highlights the importance and necessity of the prompt diagnosis and treatment of infective endocarditis and makes the reader aware of uncommon and rare organisms, such as Aerococcus urinae, as potential etiologies.

Aerococcus urinaeurinary tract infection in a hospitalised patient: an increasingly common infection

“…A. urinae urinary tract infection can potentially cause invasive illness if left untreated, including urosepsis and infective endocarditis 2 6. More recent cases of potentially life-threatening consequences have also been traced to A. urinae infection, including aortic root abscess and necrotising urethritis 4 5 .…”

“…However, it has been questioned whether the incidence of A. urinae urinary tract infections may be higher than expected due to its frequent misclassification during culturing and inherent pathogenicity towards a specific patient population 1. An increasing incidence poses a significant danger to the at-risk population due to the potentially fatal complications arising from the untreated disease, such as infective endocarditis, urosepsis, aortic root abscess or necrotising urethritis 1 4–6. We describe a case of A. urinae urinary tract infection in a hospitalised elderly male with several comorbid medical conditions.…”