Abstract
BackgroundNative valves infective endocarditis due to Escherichia coli is still a rare disease and a particular virulence of some E.coli isolate may be suspected.Case presentationA 79-year-old woman presented during the post-operative period of an orthopedic surgery a urinary tract infection following obstructive ureteral lithiasis. E. coli was isolated from a pure culture of urine and blood sampled simultaneously. After evidence of sustained E.coli septicemia, further investigations revealed acute cholecystitis with the same micro-organism in biliary drainage and a native valve mitral endocarditis. E.coli was identified as O2:K7:H6, phylogenetic group B2, ST141, and presented several putative and proven virulence genes. The present isolate can be classified as both extra-intestinal pathogenic E.coli (ExPECJJ) and uropathogenic E. coli (UPECHM).ConclusionsThe relationship between the virulent factors present in ExPEC strains and some serotypes of E. coli that could facilitate the adherence to cardiac valves warrants further investigation.
Highlights
Native valves infective endocarditis due to Escherichia coli is still a rare disease and a particular virulence of some E.coli isolate may be suspected.Case presentation: A 79-year-old woman presented during the post-operative period of an orthopedic surgery a urinary tract infection following obstructive ureteral lithiasis
In most of the reported cases, endocarditis originated from a urinary tract infection and in a recent retrospective analysis, of the published cases, 52% of patients had a preceding urinary tract infection [1]
It has been shown that some co-morbidities, such as diabetes, malignancy, excessive alcohol consumption, hemodialysis could predispose to E. coli infective endocarditis [1]
Summary
Native valves infective endocarditis due to Escherichia coli is still a rare disease and a particular virulence of some E.coli isolate may be suspected.Case presentation: A 79-year-old woman presented during the post-operative period of an orthopedic surgery a urinary tract infection following obstructive ureteral lithiasis. Background Native valves infective endocarditis due to Escherichia coli is still a rare disease, but can be observed with an increasing frequency among older women who usually present additional risk factors [1]. It usually develops as a complication of urinary tract infection, and in this case, caused by an E. coli strain harboring an array of virulence factors.
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