Microbiology & Infectious Diseases

Biography

Biography: Jorge Roberto Mosqueira Sánchez

Abstract

Native valve endocarditis due to Staphylococcus aureus in a non-intravenous drug user: Case report and review of the literature. Infective endocarditis (IE) is an uncommon but potentially lethal infectious disease. Staphylococcus aureus represents a virulent organism that causes serious complications once intracardiac infection is established. We present a 51 year-old Latin-American man, civil construction worker, admitted to our hospital with a diagnosis of Pyelonephritis. Three days after being admitted, a positive urine culture for Staphylococcus aureus was reported. Indeed, on the physical exam, a new onset of heart murmur and Janeway lesions were found. Due to high suspicion of bacterial endocarditis, he was started on Meropenem 1 g (t.i.d) and Vancomycin 1 g (b.i.d); then this diagnosis was confirmed by two positive blood cultures for Staphylococcus aureus and by a transesophageal echocardiogram (TEE) that showed vegetation on the bicuspid aortic valve, a possible mitral valve aneurysm and severe mitral regurgitation. Double valve replacement was done, however, the severity of the disease also involve other organs as kidney and spleen, complicating the management of the patient. In this non-intravenous drug user man, we identify important risk factors as a bicuspid aortic valve and the patient’s occupation, where traumatic inoculation of various microorganisms can occur. The positive urine culture can be explained by bacteremia leading to Staphylococcus aureus bacteriuria, since this patient denied recent placement of urinary catheter or urinary tract instrumentation. Staphylococcus aureus native valve IE is associated with high morbidity and mortality despite improved diagnostic tools and expanded-spectrum antibiotics.