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Native-valve endocarditis caused by Achromobacter xylosoxidans: a case report and review of literature

Caio Godoy Rodrigues; Jairo Rays; Marcia Yoshie Kanegae

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ABSTRACT: Achromobacter xylosoxidans is a Gram-negative aerobic bacterium first described by Yabuuchi and Ohyama in 1971. A. xylosoxidans is frequently found in aquatic environments. Abdominal, urinary tract, ocular, pneumonia, meningitis, and osteomyelitis are the most common infections. Infective endocarditis is rare. As far as we know, until now, only 19 cases have been described, including this current report. We report the case of community-acquired native valve endocarditis caused by A. xylosoxidans in an elderly patient without a concomitant diagnosis of a malignancy or any known immunodeficiency. The patient presented with a 2-month history of fever, weight loss, and progressive dyspnea. On physical examination, mitral and aortic murmurs were present, along with Janeway’s lesions, and a positive blood culture for A. xylosoxidans. The transesophageal echocardiogram showed vegetation in the aortic valve, which was consistent with the diagnosis of infective endocarditis.


Achromobacter, Infective Endocarditis, Native-Valve Endocarditis


Yabuuchi E, Oyama A. Achromobacter xylosoxidans n. sp. from human ear discharge. Jpn J Microbiol. 1971;15(5):477-81. [PMID:5316576] [].

Derber C, Elam K, Forbes BA, Bearman G. Achromobacter species endocarditis: a case report and literature review. Can J Infect Dis Med Microbiol. 2011;22(3):e17-20. [PMID:22942890] [].

Gómez-Cerezo J, Suárez I, Ríos JJ, et al. Achromobacter xylosoxidans bacteremia: a 10-year analysis of 54 cases. Eur J Clin Microbiol Infect Dis. 2003;22(6):360-3. [PMID:12750959] [].

Duggan JM, Goldstein SJ, Chenoweth CE, Kauffman CA, Bradley SF. Achromobacter xylosoxidansbacteremia: report of four cases and review of the literature. Clin Infect Dis. 1996;23(3):569-76. [PMID:8879782] [].

Kumar S, Khaira J, Penigalapati D. Native valve endocarditis in a dialysis patient by Achromobacter xylosoxidans: Rare pathogen. Open Forum Infect Dis. 2016;3(Suppl 1):1106. [].

Bhattarai M, Papireddy M, Kulkarni S. A rare case of complicated Achromobacter xylosoxidans endocarditis and its successful management. J Hosp Med. 2016;11(Suppl 1). [cited 2017 Apr 28]. Available from:

Levoy CS, Hall DJ, Berman D. Achromobacter xylosoxidans endocarditis and septic arthritis in an infant affected by generalized arterial calcification of infancy. JMM Case Rep. 2015;2(6) [].

Rafael AE, Keshavamurthy S, Sepulveda E, Miranda CC, Okamoto T, Pettersson GB. Intracardiac abscess with cutaneous fistula secondary to ventricular septal defect repair simulating sternal wound infection. Tex Heart Inst J. 2014;41(3):324-6. [PMID:24955054] [].

Sawant AC, Srivatsa SS, Castro LJ. Alcaligenes xylosoxidans endocarditis of a prosthetic valve and pacemaker. Tex Heart Inst J. 2013;40(1):95-8. [PMID:23466992]

Tokuyasu H, Fukushima T, Nakazaki H, Shimizu E. Infective endocarditis caused by Achromobacter xylosoxidans: a case report and review of the literature. Intern Med. 2012;51(9):1133-8. [PMID:22576403] [].

Storey A, Wilson A, McWilliams E. Native valve infective endocarditis due to Achromobacter xylosoxidans in an apparently immunocompetent individual. BMJ Case Rep. 2010;2010(1):1. [PMID:22798095] [].

Malek-Marín T, Arenas MD, Perdiguero M, et al. A case of endocarditis of difficult diagnosis in dialysis: could “pest” friends be involved? Clin Nephrol. 2009;72(5):405-9. [PMID:19863886] [].

Ahmed MS, Nistal C, Jayan R, Kuduvalli M, Anijeet HK. Achromobacter xylosoxidans, an emerging pathogen in catheter-related infection in dialysis population causing prosthetic valve endocarditis: a case report and review of literature. Clin Nephrol. 2009;71(3):350-4. [PMID:19281752] [].

Van Hal S, Stark D, Marriott D, Harkness J. Achromobacter xylosoxidans subsp. xylosoxidans prosthetic aortic valve infective endocarditis and aortic root abscesses. J Med Microbiol. 2008;57(Pt 4):525-7. [PMID:18349376] [].

Yang CH, Shih NC, Lu DCT. Infective endocarditis due to Achromobacter xylosoxidans associated with spondylodiscitis: a case report. J Int Med Taiwan. 2007;18(4):212-6.

Nanuashvili A, Kacharava G, Jashiashvili N. A case of native valve endocarditis caused by Alcaligenes xylosoxidans. Euro Surveill. 2007;12(5):1. [PMID:17868590]

Ahn Y, Kim NH, Shin DH, et al. Pacemaker lead endocarditis caused by Achromobacter xylosoxidans. J Korean Med Sci. 2004;19(2):291-3. [PMID:15082906] [].

Martino P, Micozzi A, Venditti M, et al. Catheter-related right-sided endocarditis in bone marrow transplant recipients. Rev Infect Dis. 1990;12(2):250-7. [PMID:2330480] [].

Davis M, Gratten M, Ree GH. Infective endocarditis cause by Actinobacillus actinomycetemcomitans and Achromobacter xylosoxidans. P N G Med J. 1982;25(1):7-11. [PMID:6957084]

Olson DA, Hoeprich PD. Postoperative valve endocarditis due to Achromobacter xylosoxidans. West J Med. 1982;136(2):153-7. [PMID:7064475]

Lofgren RP, Nelson AE, Crossley KB. Prosthetic valve endocarditis due to Achromobacter xylosoxidans. Am Heart J. 1981;101(4):502. [PMID:7211679] [].

Prendergast BD. The changing face of infective endocarditis. Heart. 2006;92(7):879-85. [PMID:16216860] [].

Gregoratos G. Infective endocarditis in the elderly: diagnosis and management. Am J Geriatr Cardiol. 2003;12(3):183-9. [PMID:12732814] [].

Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30(4):633-8. [PMID:10770721] [].

Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis. Eur Heart J. 2015;36(44):3036-7. [PMID:26590409] [].

Evangelista A, Gonzalez-Alujas MT. Echocardiography in infective endocarditis. Heart. 2004;90(6):614-7. [PMID:15145856] [].

Erbel R, Rohmann S, Drexler M, et al. Improved diagnostic value of echocardiography in patients with infective endocarditis by transesophageal approach. A prospective study. Eur Heart J. 1988;9(1):43-53. [PMID:3345769] [].

Shapiro SM, Young E, De Guzman S, et al. Transesophageal echocardiography in diagnosis of infective endocarditis. Chest. 1994;105(2):377-82. [PMID:8306732] [].

Luaces M, Vilacosta I, Fernández C, et al. Vegetation size at diagnosis in infective endocarditis: influencing factors and prognostic implications. Int J Cardiol. 2009;137(1):76-8. [PMID:18694604] [].

Leitman M, Dreznik Y, Tyomkin V, Fuchs T, Krakover R, Vered Z. Vegetation size in patients with infective endocarditis. Eur Heart J Cardiovasc Imaging. 2012;13(4):330-8. [PMID:22109247] [].

Chandrasekar PH, Arathoon E, Levine DP, Chandrasekar PH. Infections due to Achromobacter xylosoxidans. Case report and review of literature. Infection. 1986;14(6):279-82. [PMID:3818105] [].

Raghuraman K, Ahmed NH, Baruah FK, Grover RK. Achromobacter xylosoxidans: bloodstream infection in an elderly patient with hepatocellular carcinoma: case report and review of the literature. J Lab Phys. 2015;7(2):124-7. [PMID:26417165]

Ng ZY, Fang G, Leo KW. Resolution of concomitant Achromobacter xylosoxidans burn wound infection without adjustment of antimicrobial therapy. Indian J Plast Surg. 2014;47(1):137-40. [PMID:24987220] [].








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