Evidence Hub

Endocarditis caused by Aerococcus urinae: a case report and review of literature

Giovanni G, Virgilio PM, Bruno G, Maria M, Marta B, Giuseppe S, Paolo S

Journal of medical case reports, 2026

Abstract

BACKGROUND: Infective endocarditis is an infectious disease associated with high morbidity and mortality; incidence has been increasing in recent decades. Most common causes of infective endocarditis are Staphylococcus aureus, Streptococci, and Enterococci. Bacteria of the genus Aerococcus are not frequent etiological agents of endocarditis; Aerococcus urinae is a gram-positive bacterium that usually causes common urinary tract infections but can sometimes cause invasive infections such as infective endocarditis. In the past, incidence of Aerococcus urinae infections has likely been underestimated because of its morphological features similar to Staphylococci and Streptococci.

CASE PRESENTATION: We describe the case of a 74-year-old Italian woman with mitral valve endocarditis who presented to the emergency department with focal neurological symptoms associated with cerebral septic embolization; despite the development of severe mitral insufficiency, the size of the vegetation, and the presence of septic embolization, the patient could not be treated with surgical valve replacement in the short term owing to the hemorrhagic evolution of the cerebral lesions, which contraindicated extracorporeal circulation. Antibiotic treatment with ampicillin and levofloxacin was administered for 8 weeks, and after that, the patient was transferred to a rehabilitation unit.

LITERATURE REVIEW AND CONCLUSION: We analyzed cases of infective endocarditis due to Aerococcus urinae described so…

How strong is the evidence?

Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free