Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2021.381
Autopsy and Case Reports
Autopsy Case Report

Dual pathogen valvular endocarditis in a case of severe aortic aneurysm

Meghna Yadav; Rohit Tewari; Tathagata Chatterjee

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Abstract

Infective endocarditis (IE) is the heart valve or endocardium infection. We report a rare case of polymicrobial endocarditis, namely invasive Aspergillus spp and Acinetobacter baumannii, in a 36-year-old male with a medical history of degenerative disease of the aorta with abdominal aortic and ascending aortic aneurysms with a fulminant clinical course and fatal outcome. The treatment was challenging due to multiple comorbidities. The autopsy revealed dual pathogen endocarditis due to Acinetobacter baumannii sepsis and invasive Aspergillus spp mycosis. This report emphasizes that polymicrobial endocarditis (PE) is an infrequent finding with a poor prognosis requiring high clinical suspicion.

Keywords

Endocarditis, Acinetobacter baumannii, Aneurysm, Aspergillus

References

1 Murdoch DR, Corey GR, Hoen B, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis- Prospective Cohort Study. Arch Intern Med. 2009;169(5):463-73. http://dx.doi.org/10.1001/archinternmed.2008.603. PMid:19273776.

2 Peters BM, Jabra-Rizk MA, O’May GA, Costerton JW, Shirtliff ME. Polymicrobial interactions: impact on pathogenesis and human disease. Clin Microbiol Rev. 2012;25(1):193-213. http://dx.doi.org/10.1128/CMR.00013-11. PMid:22232376.

3 Al-Anazi KA, Al-Jasser AM. Infections caused by acinetobacter baumannii in recipients of hematopoietic stem cell transplantation. Front Oncol. 2014;4:186. http://dx.doi.org/10.3389/fonc.2014.00186. PMid:25072028.

4 Pierrotti LC, Baddour LM. Fungal endocarditis, 1995-2000. Chest. 2002;122(1):302-10. http://dx.doi.org/10.1378/chest.122.1.302. PMid:12114375.

5 Murray JL, Connell JL, Stacy A, Turner KH, Whiteley M. Mechanisms of synergy in polymicrobial infections. J Microbiol. 2014;52(3):188-99. http://dx.doi.org/10.1007/s12275-014-4067-3. PMid:24585050.

6 Valencia Ortega ME, Enríquez Crego A, Guinea Esquerdo J, González Lahoz J. Polymicrobial endocarditis: a clinical and evolutive study of 12 cases diagnosed during a 10-year period. Rev Clin Esp. 1997;4(4):245-7. PMid:9254400.

7 Schønheyder HC, Jensen HE, Gams W, et al. Late bioprosthetic valve endocarditis caused by Phialemonium aff. curvatum and Streptococcus sanguis: a case report. J Med Vet Mycol. 1996;34(3):209-14. http://dx.doi.org/10.1080/02681219680000351. PMid:8803803.

8 Degeorges M, Heintz C, Valty J, Drouhet E, Acar JF, Leduc G. Infectious endocarditis due to Listeria monocytogenes and Cephalosporium. Presse Med. 1971;79(30):1377-80. PMid:4999166.

9 Sabir N, Ikram A, Gardezi A, et al. Native valve dual pathogen endocarditis caused by Burkholderia cepacia and Aspergillus flavus - a case report. JMM Case Rep. 2018;5(9):e005143. http://dx.doi.org/10.1099/jmmcr.0.005143. PMid:30425834.

10 Popescu GA, Prazuck T, Poisson D, Picu C. A “true” polymicrobial endocarditis: candida tropicalis and Staphylococcus aureus-- to a drug user. Case presentation and literature review. Rom J Intern Med. 2005;43(1-2):157-61. PMid:16739876.

11 Mennink-Kersten MA, Donnelly JP, Verweij PE. Detection of circulating galactomannan for the diagnosis and management of invasive aspergillosis. Lancet Infect Dis. 2004;4(6):349-57. http://dx.doi.org/10.1016/S1473-3099(04)01045-X. PMid:15172343.

12 Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(3):327-60. http://dx.doi.org/10.1086/525258. PMid:18177225.

13 Menon T, Shanmugasundaram S, Nandhakumar B, Nalina K, Balasubramaniam. Infective endocarditis due to Acinetobacter baumannii complex--a case report. Indian J Pathol Microbiol. 2006;49(4):576-8. PMid:17183861.

14 Cheon S, Yang MK, Kim CJ, et al. Disseminated Aspergillosis in the immunocompetent host: a case report and lit- erature review. Mycopathologia. 2015;180(3-4):217-22. http://dx.doi.org/10.1007/s11046-015-9903-4. PMid:26016845.

15 Francischetto O, Silva LA, Senna KM, et al. Healthcare-associated infective endocarditis: a case series in a referral hospital from 2006 to 2011. Arq Bras Cardiol. 2014;103(4):292-8. http://dx.doi.org/10.5935/abc.20140126. PMid:25352503.

16 Giannitsioti E, Skiadas I, Antoniadou A, et al. Nosocomial vs. community-acquired infective endocarditis in Greece: changing epidemiological profile and mortality risk. Clin Microbiol Infect. 2007;13(8):763-9. http://dx.doi.org/10.1111/j.1469-0691.2007.01746.x. PMid:17488327.
 


Submitted date:
06/08/2021

Accepted date:
04/14/2022

Publication date:
05/05/2022

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