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Case Reports
. 2024 Mar 11:11:20499361241237617.
doi: 10.1177/20499361241237617. eCollection 2024 Jan-Dec.

Infective endocarditis due to Citrobacter koseri following testicular trauma: case report and literature review

Julian Orlando Casallas-Barrera  1 , Claudia Marcela Poveda-Henao  2 , Karen Andrea Mantilla-Viviescas  3 , Edwin Silva-Monsalve  4
Affiliations
Case Reports

Infective endocarditis due to Citrobacter koseri following testicular trauma: case report and literature review

Julian Orlando Casallas-Barrera et al. Ther Adv Infect Dis. .

Abstract

Infective endocarditis (IE) is a condition with low prevalence but high mortality rates within intensive care units. Microbiologically, most cases are attributed to Gram-positive cocci, while Gram-negative bacilli are less commonly involved. This case report describes a patient with IE caused by Citrobacter koseri (C. koseri) with secondary bacteremia due to blunt testicular trauma and epididymitis. We conducted a review of the literature to assess the clinical and associated risk factors of this underreported condition. Elderly and urinary tract infections could be associated with this entity. Cefazolin was used as the final targeted treatment. The use of precision medicine in IE is required for specific interventions.

Keywords: Citrobacter koseri; case report; epididymitis; infective endocarditis; risk factors.

Plain language summary

Infection of the heart valve from testicular injury: a case study and review of medical literature Infective endocarditis (IE) is a serious but rare infection that can lead to death, especially in intensive care units. Typically, it’s caused by certain types of bacteria, but our case study focuses on a patient whose IE was caused by a less common bacterium called Citrobacter koseri (C. koseri). This infection occurred after the patient experienced blunt trauma to the testicles, leading to a bloodstream infection. We looked at other similar cases in medical literature and found that older age and urinary tract infections might increase the risk of this type of IE. In this case, IE caused by this unusual bacteria was treated with cefazolin.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Cerebral MRI. (a, b) T2 weighted and FLAIR – right pontine infarction (red arrow). (c, d) T2 weighted and FLAIR – subcortical and deep white matter hyperintensities compatible with multiple septic embolisms (red arrows). FLAIR, fluid attenuation inversion recovery; MRI, magnetic resonance imaging.
Figure 2.
Figure 2.
Transesophageal echocardiogram. (a, b) Two masses, one measuring 19 mm × 8 mm and the other 13 mm × 9 mm, are attached to the atrial wall of the mitral valve (red arrows). (c) Three-dimensional image of the mitral valve mass (red arrow). (d) Severe mitral valve insufficiency (yellow arrow).
See this image and copyright information in PMC

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