Early bioprosthetic aortic valve endocarditis from dual bacterial pathogens including a HACEK microorganism (Cardiobacterium hominis)

Abstract

This article presents Bacillus thuringiensis, a new pathogen implicated in causing infective endocarditis, in combination with Cardiobacterium hominis, which has never been reported in a dual pathogen endocarditis scenario.This is the first reported case of dual pathogen HACEK endocarditis that was identified by the authors. Our patient presented with a subacute course of infective symptoms and investigations found prosthetic valve endocarditis with C. hominis and B. thuringiensis. This is the first instance where B. thuringiensis has been implicated in infective endocarditis, where it was thought to previously be non-pathogenic. This is the nineteenth case of C. hominis prosthetic valve endocarditis and eighth case of C. hominis prosthetic valve endocarditis requiring re-do surgery reported in the English language.The pathogens isolated in this instance provide insight into causative pathogens and appropriate treatment modalities for successful management of sub-acute bioprosthetic infective endocarditis.