An Unusual cause of Endocarditis

• Published in: BMJ case reports Vol. 15; no. 12; p. e249214
• Main Authors: Watkins, Rhys, Marincowitz, Carl, Locke, Thomas, Hunter, Steven
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 21.12.2022
• Subjects: Analgesics; Antibiotics; Beta blockers; Case reports; Coronaviruses; COVID-19; Dental Caries; Diagnostic tests; Endocarditis; Endocarditis, Bacterial - complications; Endocarditis, Bacterial - diagnosis; Endocarditis, Bacterial - surgery; Endodontics; Heart surgery; Humans; Infections; Infectious diseases; Kidneys; Male; Meningitis; Mitral Valve - surgery; Surgeons; Ultrasonic imaging; Viral infections; East Asia; Valvar diseases; Cardiothoracic surgery; Infectious diseases; Cardiovascular medicine; Emergency medicine
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2022-249214

A man in his 20s attended the emergency department with three days of fever, headache, reduced appetite and a sore throat. COVID-19 point-of-care test was negative. Blood cultures grew a gram-negative coccobacillus, Following an episode of confusion, MRI head revealed septic emboli. Prolapse of the mitral valve with regurgitation was noted on echocardiography. Infection was found to have originated from multiple dental caries and treatment required a combination of dental extraction, prolonged antibiotic therapy and surgery for mitral valve repair. is part of the normal oropharyngeal flora but is also a rare cause of endocarditis. There are no established treatment guidelines for endocarditis of this aetiology. endocarditis may present atypically, with a murmur only developing several days later. 'Classical' stigmata should not be relied on to make a diagnosis. predominantly affects the left side of the heart and predisposes to embolic events.