An unusual etiology of infective endocarditis: Enterobacter cloacae

Moon, Juhi; Smith, Triston; Sahud, Andrew G.; Bhanot, Nitin

doi:10.1007/s10156-012-0376-9

Cited by 13 publications

(12 citation statements)

References 34 publications

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“…In the case of Enterobacter endocarditis, a close anatomical comparator to our patient's pericardial effusion, combination therapy has been traditionally used 12. Emerging evidence in this relatively uncommon condition suggests that combination antimicrobial therapy is not synergistically beneficial 12.…”

Section: Discussionmentioning

confidence: 98%

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Enterobacter cloacaepericardial effusion in a frail elderly patient

Blundell

Mason

2015

BMJ Case Reports

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We report a case of a frail 82-year-old man with seronegative rheumatoid arthritis and a recent pacemaker insertion, admitted with pulmonary oedema and a symptomatic pericardial effusion. He was treated with diuretics and an urgent pericardiocentesis, a sample from which cultured Enterobacter cloacae. A subsequent abdominal CT scan revealed faecal loading, an abnormal anorectal canal and sigmoid colon and a bowel perforation. Endoscopy, biopsies and histopathology confirmed a diagnosis of cytomegalovirus (CMV) colitis with coexistent fungal infection. The E. cloacae infection was successfully treated with 6 weeks of intravenous meropenem, while the CMV and fungal infections were treated with a combination of valganciclovir and fluconazole. We postulate that the bowel perforation resulted from a combination of CMV colitis, faecal loading and steroid therapy and led to bacterial translocation of E. cloacae and the development of the pericardial effusion. This case represents an unusual pathophysiology for the development of an E. cloacae pericardial effusion.

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Section: Discussionmentioning

confidence: 98%

“…Emerging evidence in this relatively uncommon condition suggests that combination antimicrobial therapy is not synergistically beneficial 12. It does not draw conclusions regarding the effects on antibiotic resistance 12…”

Section: Discussionmentioning

confidence: 99%

Enterobacter cloacaepericardial effusion in a frail elderly patient

Blundell

Mason

2015

BMJ Case Reports

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“…It has also been reported that non-HACEK gram-negative bacterial endocarditis has a high mortality risk. A case series reviewing Enterobacter endocarditis reported a 37.7% mortality rate [ 13 ]. Our patient was previously followed for a catheter-related bloodstream infection associated with a sensitive Enterobacter strain.…”

Section: Discussionmentioning

confidence: 99%

“…Although successful results have been reported with monotherapy in the treatment of Enterobacter -associated IE, the European Society of Cardiology guidelines recommend early surgical intervention and at least 6 weeks of β-lactam and aminoglycoside treatment, with the addition of quinolones or cotrimoxazole when advised by specialists [ [13] , [14] ]. In addition, in an animal model of Enterobacter aerogenes endocarditis, the addition of gentamicin to aztreonam and cefoperazone treatment promoted faster and more comprehensive reduction of vegetation titers, thus demonstrating the superiority of combination therapy [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A rare cause of healthcare-associated infective endocarditis: Enterobacter cloacae

Karaşahin

Yıldız

Ünal

et al. 2018

IDCases

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We report a case of infective endocarditis secondary to healthcare-associated bloodstream infection caused by an uncommon etiologic agent, multidrug-resistant Enterobacter cloacae. The patient was treated with a combination of antimicrobial therapy and surgery, but could not be saved. With this case, we discuss the prevalence, risk factors, treatment options, and outcomes of the rarely encountered Enterobacter cloacae-associated infective endocarditis.

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“…Risk factors of IE by non-HACEK group include intravenous drug abuse, healthcare contact and the presence of prosthetic cardiac devices (1). Here we report a review of two cases of complicated Enterobacter endocarditis.…”

Section: Introductionmentioning

confidence: 95%