Elusive Enterobacter cloacae causing pacemaker endocarditis

Naji Maaliki; Jorge Verdecia; Malleswari Ravi

doi:10.1016/j.idcr.2021.e01149

Elusive Enterobacter cloacae causing pacemaker endocarditis

IDCases. 2021 May 7:24:e01149. doi: 10.1016/j.idcr.2021.e01149. eCollection 2021.

Authors

Naji Maaliki¹, Jorge Verdecia², Malleswari Ravi²

Affiliations

¹ Department of Internal Medicine, University of Florida COM-Jacksonville, 4th Floor, 655 8th W 8th Street, Jacksonville, FL, USA.
² Department of Infectious Diseases, University of Florida COM-Jacksonville, 655 8th W 8th Street, Jacksonville, FL, USA.

Abstract

An 80-year-old patient was admitted for fever, chills, and chest wall pain. He had a past medical history significant for heart failure with a cardiac resynchronization therapy pacemaker implantation. Extensive workup revealed Enterobacter cloacae endocarditis of the pacemaker leads and the mitral valve, a rare etiology with an unidentified source in our patient. He was managed with a rather unconventional method which proved to be successful. This case sheds light on non-HACEK (other than Haemophilus spp., Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella spp). gram-negative organisms, and particularly E. cloacae, as uncommon causes of endocarditis with elevated mortality, and discusses potential treatment modalities.

Keywords: Cardiac implantable electronic device endocarditis; Endocarditis; Enterobacter cloacae; Non-HACEK gram-negative rods; Pacemaker endocarditis.

Publication types

Case Reports