‘TAVR Infected Pseudomonas Endocarditis’: a case report
Abstract
Pseudomonas aeruginosa (P. aeruginosa) rarely causes infective endocarditis (IE), previously reported for approximately 3% of all patients with IE.1 Most commonly, the infection occurs in intravenous drug users (IVDU) as right-sided endocarditis, noting presentations of P. aeruginosa IE without history of intravenous drug to be extremely rare, finding only a few cases reported in the literature. However there are increasing reports of cardiovascular implantable electronic device–related and prosthetic heart valve infections caused by this pathogen in non-IVDUs.2 This report will focus on the clinical presentation, management, and outcome of P. aeruginosa endocarditis in an 89-year-old patient with a transcatheter aortic valve replacement (TAVR). Medical management was pursued due to the patient’s underlying comorbidities. Long-term suppressive antibiotic therapy with delafloxacin was successful in maintaining negative blood cultures, despite an allergy to levofloxacin and ciprofloxacin. Plain Language Summary An 89-year-old male was admitted to our hospital after he was diagnosed with a blood stream infection. The initial identification noted gram-negative organisms consistent with Pseudomonas Aeruginosa so the patient was started on intravenous (IV) antibiotics. He improved after the antibiotics started and was discharged to a nursing facility to complete his antibiotics course. While at the facility, after he had finished his antibiotics, he started to become ill again. He…
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