Dual valve Achromobacter endocarditis in a long-term acute care unit: a case report and review of the literature
Abstract
Background: Achromobacter xylosoxidans is an opportunistic, gram-negative organism that primarily affects immunocompromised individuals or those with indwelling medical devices. Although generally considered of low virulence, it has been increasingly recognized as a cause of serious infections, including infective endocarditis (IE), which is associated with significant morbidity and mortality and often poses therapeutic challenges.
Case presentation: We present the case of a 69-year-old Middle Eastern woman with a complex medical history significant for coronary artery bypass grafting, end-stage renal disease requiring hemodialysis via a tunneled catheter, chronic respiratory failure secondary to tracheomalacia, atrial fibrillation, and persistent vegetative state following a prior cardiac arrest. The patient was transferred from the intensive care unit to a long-term acute care facility and subsequently developed recurrent polymicrobial bacteremia. Blood cultures repeatedly isolated Achromobacter xylosoxidans despite targeted antimicrobial therapy. Transthoracic echocardiography revealed a small mobile vegetation on the posterior mitral valve leaflet associated with mild-to-moderate mitral regurgitation. A follow-up study approximately 1 month later demonstrated new aortic valve involvement, consistent with disease progression. Despite antimicrobial therapy guided by susceptibility testing and catheter exchange, persistent bacteremia continued. Surgical intervention was…
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.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
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.