P57 INFECTIVE ENDOCARDITIS OF PROSTHETIC MITRAL VALVE, CAUSED BY ACINETOBACTER BAUMANNII

Abstract

Introduction: Acinetobacter baumannii is a causative agent of nosocomial infections; it is very difficult to identify and treat, which is a good explanation for its high lethality. Aim: To introduce the case of a patient with infective endocarditis of a prosthetic mitral valve caused by Acinetobacter baumannii, who survived this infection. The patient is a 65-year-old female. She came to the emergency room on April 10, 2012 with high fever, chills, dyspnea and clinical features of encephalopathy. Her anamnesis showed a surgical intervention of the mitral and aortic valves, one month ago. TEE revealed small hypoechogenic vegetations in the mitral valve. Three weeks after the hospitalization, the patient underwent another intervention, which consisted of another replacement of the mitral and aortic valves. The blood cultures were negative, while the cultures of the valves evidenced the growth of Acinetobacter baumannii. The bacteria was resistant to ampicillin, augmentin and imipenem. The patient was treated with imipenem in the beginning, but after the antibiogram she was treated with more effective antibiotics, such as piperacillin– tazobactam and ciprofloxacin. The patient had good response to this treatment (temperature normalized after 7 days, and TTE showed no verrucas after 6 weeks of therapy). The patient is presently in good condition according to periodic clinical and imaging follow up.