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

Elusive Enterobacter cloacae causing pacemaker endocarditis

Naji Maaliki  1 , Jorge Verdecia  2 , Malleswari Ravi  2
Affiliations
Case Reports

Elusive Enterobacter cloacae causing pacemaker endocarditis

Naji Maaliki et al. IDCases. .

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.

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Conflict of interest statement

The authors report no declarations of interest. There was no funding for this manuscript.

Figures

Fig. 1
Fig. 1
Erythema and swelling around CRT-P insertion site.
Fig. 2
Fig. 2
TEE revealing vegetation at the anterior leaflet of the mitral valve.
Fig. 3
Fig. 3
3D TEE demonstrating an anterior vegetation on the Mitral valve.
Fig. 4
Fig. 4
Respective MIC per Antimicrobial for E. cloacae.
See this image and copyright information in PMC

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