Steak tartare endocarditis

Abstract

This report describes a case of Campylobacter fetus prosthetic valve infective endocarditis and discusses the subsequent management. Although C. fetus has a tropism for vascular endothelium, infective endocarditis has rarely been reported. In this patient, despite initial optimal antimicrobial therapy, valve replacement was ultimately required due to ongoing infectious emboli to the brain in the setting of evidence of vegetation enlargement on echocardiogram. The prosthetic valve was replaced, the patient completed a 6-week course of parenteral antibiotics after surgical intervention and he made a full recovery with no long-term neurological sequelae. This case highlights the fact that despite the relatively low prevalence of C. fetus endocarditis, it is associated with a high degree of mortality and valve replacement is often indicated.

Figure 1

Gram stain with arrow demonstrating a Gram-negative organism, ultimately identified as Campylobacter fetus. A red blood cell is also noted for comparison.

Figure 2

Acridine orange stain with arrows demonstrating an organism showing the classic gull-wing morphology seen with Campylobacter species. A red blood cell is also noted for comparison.

Figure 3

Transoesophageal echocardiogram showing a vegetation along the left aortic sinus (contained within the circle and arrow shows the vegetation and sinus).