Refractory Salmonella Prosthetic Valve Endocarditis Complicated by Splenic Infarction and Aortic Pseudoaneurysm in a Patient with Double Prosthetic Valves: A Case Report

Abstract

Endocarditis is an extremely rare complication of Salmonellosis with an incidence of 0.2–0.4%. It is a destructive and invasive infection that follows a highly complicated course and carries a high mortality rate that exceeds 45%. Multiple predisposing factors for Salmonella endocarditis have been described in the literature, including human immunodeficiency virus infection, congenital heart diseases, and the presence of a prosthetic valve. Herein, we report a case of Salmonella prosthetic valve endocarditis complicated by splenic infarction and aortic pseudoaneurysm presenting as a month-long history of fluctuating fever, chills, and rigors, accompanied by occasional cough and shortness of breath in a 55-year-old female with aortic and mitral valves replacement and multiple comorbidities. She was diagnosed by multiple radiographic studies and successfully treated with the Commando procedure and a long course of IV antibiotics.

Salmonella Enteritidis ST11 Prosthetic Valve Endocarditis Complicated by a Paravalvular Abscess: Case Report and Literature Review

“…The literature review revealed 21 case reports on Salmonella PVE and one case report on Salmonella native valve endocarditis [3,4,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The results of the literature review and our case are summarized in Table 1 and described in more detail in Table S1.…”

“…Salmonella is a common cause of enteritis and accounts for approximately 5-10% of cases of bacteremia [1,2]. It is also a rare cause of destructive endocarditis, including prosthetic valve endocarditis (PVE), which occurs in only 0.2-0.4% of cases of salmonellosis [3,4]. PVE has a high mortality rate due to complications such as conduction abnormalities, septic embolism, perforation, valve rupture, and paravalvular abscess (PA) [3,5].…”