Background
Case presentation
Hematology
| Normal range | |
White blood cellsa | 11,400/mm3 | 3300–8600/mm3 |
Red blood cells | 422 × 104/mm3 | 386–492 × 104/mm3 |
Hemoglobin | 13.2 g/dL | 11.6–14.8 g/dL |
Hematocrit | 41.2% | 35.1–44.4% |
Platelets | 19.8 × 104/mm3 | 15.8–34.8 × 104/mm3 |
Biochemistry
| ||
Total proteina | 5.5 g/dL | 6.6–8.1 g/dL |
Albumina | 2.8 g/dL | 4.1–5.1 g/dL |
Total bilirubin | 0.9 mg/dL | 0.4–1.5 mg/dL |
ASTa | 242 U/L | 13–30 U/L |
ALTa | 127 U/L | 7–23 U/L |
LDHa | 274 U/L | 124–222 U/L |
γ-GTPa | 679 U/L | 9–32 U/L |
CPK | 43 U/L | 41–153 U/L |
Amylase | 45 U/L | 44–132 U/L |
Blood urea nitrogena | 38 mg/dL | 8–20 mg/dL |
Creatininea | 1.24 mg/dL | 0.46–0.79 mg/dL |
Uric acida | 9.0 mg/dL | 2.6–5.5 mg/dL |
Sodium | 141 mEq/L | 138–145 mEq/L |
Potassiuma | 2.5 mEq/L | 3.6–4.8 mEq/L |
Chloride | 102 mE/L | 101–108 mEq/L |
Glucose | 102 mg/dL | 73–109 mg/dL |
Hemoglobin A1c | 5.5% | < 5.8% |
C-reactive proteina | 22.5 mg/dL | < 0.15 mg/dL |
BNPa | 112.6 pg/mL | < 18.5 pg/mL |
Blood coagulation tests
| ||
PT-INR | 1.02 | 0.85–1.15 |
Serology
| ||
HBsAg | Negative | Negative |
HCV-RNA | Negative | Negative |
Anti-HAV IgM Ab | Negative | Negative |
Anti-HIV Ab | Negative | Negative |
Discussion
Patients’ backgrounds
Case No. | First author, year | Age, years | Sex | Comorbidities | Pre-ceding UTI | Complications during hospitalization | Antibiotic therapy | Site of vegetation | Cardiac surgery | Outcome |
---|---|---|---|---|---|---|---|---|---|---|
1 | Murray [10] 1988 | 25 | M | None | – | Pulmonary infarction | PC + GM+ MNZ | PV | Resection of anterior PV leaflet | A |
2 | Watanakunakorn [11] 1992 | 79 | F | DM, HT | – | Hemorrhagic CI, CHF | CFX→ CAZ + GM→CZX | MV-anterior leaflet | – | D (37 days) |
3 | Raymond [12] 1992 | 52 | F | None | + E. coli positive | Abscess of IVS, CHF | CTRX | AV | – | D (8 days) |
4 | Oosterbosch [13] 1996 | 69 | F | Multiple myeloma | + E. coli positive | LV aneurysm formation, severe MR, CHF | Temocillin→CXM + AMK | MV-posterior leaflet | – | D (8 days) |
5 | Morrison [14] 1997 | 47 | M | Multiple tooth decay, chronic alcoholism, bicuspid AV | +E. coli positive | Renal infarction | CTRX | AV-RCC | AVR (MP) | A |
6 | Soma [15] 2005 | 42 | M | AS and AR, urethral stenosis | +E. coli positive | Aortic paravalvular abscess formation | TMP-SMX→CTX + GM→ABPC+netilmicin | AV, AV ring abscess | AVR (MP) | A |
7 | Branger [16] 2005 | 60 | F | Colic polyposis, AF, history of RF, IE, and post-AVR (BP) | – | Aortic regurgitation, CHF | AMPC/CVA + MNZ→AMPC+MNG + GM→CAZ + CPFX | AV (BP) | AVR (MP) | A |
8 | Branger [16] 2005 | 75 | F | DM, HT, bilateral pyelonephritis, vesicular stenosis | + E. coli positive | Cerebral infarction, mitraltendon rupture, renal failure | CTRX+OFLX | MV | MV annuloplasty | A |
9 | Branger [16] 2005 | 76 | M | RF, MS→ Post-MVR (MP), colic diverticulosis, kidney cancer | – | Renal failure | AMPC/CVA + CPFX | MV (MP) | – | A |
10 | Branger [16] 2005 | 80 | M | Ischemic cardiomyopathy, stroke, heart failure | – | Renal failure, Coxiella burnetii serology-positive, humeral osteomyelitis | AMPC+GM + DOXY+hydroxychloroquine | AV | – | D (1 month) |
11 | Branger [16] 2005 | 66 | F | MS→post-MVR (MP) | +E. coli positive | Renal failure, MV ring abscess | IPM + GM→CTRX | MV (MP), MV ring abscess | MVR (BP) | A |
12 | Branger [16] 2005 | 82 | F | DM, thyroid neoplasm | + E. coli positive | Abscess formation, MV ring abscess, perforation, pneumonia | CTRX+OFLX→AMPC+GM | MV, MV ring abscess | MVR (BP) | A |
13 | Branger [16] 2005 | 76 | F | RF, post-MVR (BP) | + | Renal failure, mitral regurgitation | Unknown | MV (BP) | Unknown | Unknown |
14 | Kulas [17] 2006 | 16 | F | Puerperal onset after a cesarean section, MR | – | – | AMPC/CVA+ GM + MNZ+ oral CLDM | MV | – | A |
15 | Foley [18] 2010 | 31 | F | – | – | Tricuspid regurgitation, septic emboli in the lung | MEPM+MNZ→Oral AMPC→IPM + GM | TV anterior leaflet | Resection of anterior TV leaflet | A |
16 | Tsutsumi [19] 2010 | 60 | M | End-stage alcoholic liver disease, blunt injury of the left arm | – | Osteomyelitis of the left sacroiliac and right sternoclavicular joints, septic emboli in the lung | CTRX→MEPM→CTRX | TV anterior leaflet | – | A |
17 | Lauridsen [20] 2011 | 67 | M | Acute acalculous cholecystitis | +E. coli positive | MR, valve perforation, LV pseudoaneurysm formation, CHF, spondylodiscitis, endophthalmitis | CXM + GM + MNZ→MEPM+GM | MV posterior leaflet | MVR (MP) | A |
18 | Fordyce [21] 2011 | 72 | M | Post-biopsy of the prostate, sciatica, PAF, AS, MS, MR | + E. coli positive | Transient complete atrioventricular block *ESBL-producing E. coli infection | CTRX→ Ertapenem→ IPM + GM | TV septal leaflet | – | A |
19 | Modi [22] 2011 | 62 | F | MR→Post-MVR (BP), old CI, PC allergy | – | - *ESBL-producing E. coli infection | AZT + VCM→IPM | MV (BP) | – | A |
20 | Senel [23] 2012 | 60 | M | Post-AVR (MP), post-hemorrhoidectomy | Unknown | First-degree atrioventricular block, pseudomembranous enteritis, AV ring abscess | SBT/ABPC→AMPC/CVA→SBT/ABPC+GM | AV (MP), AV ring abscess | AVR (MP) | A |
21 | Lupse [24] 2012 | 75 | F | Post-cholecystectomy, biliary stenosis and stenting, AR, MR | – | -*ESBL-producing E. coli infection | SBT/ABPC→IPM | AV | – | A |
22 | Rangarajan [25] 2013 | 54 | M | DM, HT, Post-meatotomy and circumcision | + | Severe MR, TIA, CHF, respiratory distress, renal dysfunction | SBT/CPZ + AMK→SBT/CPZ + LVFX | MV anterior leaflet | MVR (MP) | A |
23 | Gupta [26] 2013 | 0 | M | PDA, VSD, trisomy 18 | – | Bilateral hydroureteronephrosis | ABPC+GM→unknown | SVC-RA junction | – | A |
24 | Spaleniak [27] 2015 | 76 | F | Goodpasture’s syndrome | Unknown | Renal failure *ESBL-producing E. coli infection | IPM + CPFX→IPM + AMK | MV anterior leaflet | – | A |
25 | Chen [28] 2015 | 46 | F | Severe AR, bicuspid AV | + | Severe pulmonary hypertension, CHF | TAZ/PIPC +GM→CAZ + GM | AV and MV anterior leaflet | – | A |
26 | Tsai [29] 2015 | 40 | M | IgA nephropathy, CRF on HD | Unknown | Necrotizing fasciitis, septic shock, intracranial hemorrhage | CAZ + VCM | LV details unknown | – | D (3 weeks) |
27 | Loubet [30] 2015 | 53 | Unknown | DM, recent invasive procedure | + | -*ESBL-producing E. coli infection | IPM + AMK | AV | – | A |
28 | Loubet [30] 2015 | 82 | Unknown | Post-AVR (BP), recent invasive procedure | + | Intracardiac abscess | Unknown | AV (BP) | +Details unknown | A |
29 | Loubet [30] 2015 | 74 | Unknown | Post-MVR (MP) | – | Intracardiac abscess, systemic embolization | CTRX+AMK | MV (MP) | +Details unknown | A |
30 | Loubet [30] 2015 | 74 | Unknown | DM, post-AVR (MP) | + | Intracardiac abscess | CTX + OFLX | AV (MP) | +Details unknown | D (9 months) |
31 | Menon [31] 2017 | 58 | M | Post-renal transplant | + E. coli positive | – | CTRX+AMK | AV | – | A |
32 | Kim [32] 2018 | 80 | F | Thickened MV leaflets, DM, HT, history of pyelonephritis due to E. coli | +E. coli positive | Multiple cerebral and cerebellar infarctions, emphysematous IE *ESBL-producing E. coli infection | MEPM | MV annulus | – | D (39 days) |
33 | Akuzawa 2018 | 58 | F | Alcohol abuse | – | Purulent spondylitis | SBT/ABPC +GM→MEPM+GM | MV anterior leaflet and chordae tendineae | – | A |
Background comorbidities of E. coli IE
Prosthetic valve endocarditis and native valve endocarditis
Prosthetic valve endocarditis (n = 9) | Native valve endocarditis (n = 22) | |
---|---|---|
Patients’ characteristics
| ||
Age, years | 70.0 ± 7.65 | 59.7 ± 18.3 |
Sex | ||
Male | 2 | 13 |
Female | 4 | 8 |
Unknown | 3 | 1 |
Infected valves
| ||
Aortic valve | 4 | 7 |
Mitral valve | 5 | 10 |
Aortic + mitral valves | 0 | 1 |
Tricuspid valve | 0 | 3 |
Pulmonary valve | 0 | 1 |
Types of prosthetic valves
| ||
Aortic valve | ||
Biological | 2 | – |
Mechanical | 2 | – |
Mitral valve | ||
Biological | 2 | – |
Mechanical | 3 | – |
Preexisting valvulopathy in native valves
| ||
Aortic valve | – | 3 |
Mitral valve | – | 2 |
Aortic + mitral valves | – | 2 |
Tricuspid valve | – | 0 |
Pulmonary valve | – | 0 |