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Case Reports
. 2024 Oct 15;16(10):e71548.
doi: 10.7759/cureus.71548. eCollection 2024 Oct.

Burkholderia cepacia Infective Endocarditis of Native Aortic Valve: A Case Report and Review of Literature

Isa Almubarak  1 , Abdulla J Almubarak  2 , Yusuf A Ahmed  3 , Manar A Ali  2 , Walaa H Yusuf  3 , Mariam Ismail  4 , Shady Elhadidi  5 , Hanaa Abdelaziz  6 , Mohamed A Gabr  5 , Gehad Awad  5
Affiliations
Case Reports

Burkholderia cepacia Infective Endocarditis of Native Aortic Valve: A Case Report and Review of Literature

Isa Almubarak et al. Cureus. .

Abstract

Infective endocarditis (IE) is a serious cardiac infection of the endocardium, native and prosthetic valves, or cardiac device. In this case study, we report a case of an immunocompetent patient with severe Burkholderia cepacia aortic valve endocarditis. A 54-year-old female presented to the emergency department with progressive shortness of breath, chest pain, palpitations, and cough for a period of 20 days. On physical examination, the patient was orthopneic, tachypneic, and tachycardic with an irregularly irregular rhythm. Her blood pressure was 110/80, with an oxygen saturation of 88% on room air. On auscultation, variable S1 intensity, weak S2, ejection systolic murmurs all over the precordium, and bilateral crepitations were heard over lung bases. Electrocardiography was performed, which showed atrial fibrillation with rapid ventricular response. Transthoracic echocardiography and transesophageal echocardiography were performed, which revealed a large aortic valve mass causing severe valvular obstruction. Blood culture results were non-conclusive. Autoimmune laboratory workup was conducted to exclude systemic lupus erythematosus and antiphospholipid syndrome. The patient received loop diuretics and empirical antibiotics initially, and an urgent surgical aortic valve replacement was performed. Burkholderia cepacia was detected by microbiological analysis of the excised valve. Amoxicillin/clavulanic acid was given for a period of four weeks post-operatively. Burkholderia cepacia could be one of the causative organisms causing IE and can affect the aortic valve in immunocompetent patients.

Keywords: aortic valve mass; aortic valve replacement; burkholderia cepacia; case report; infective endocarditis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Transthoracic echocardiography (parasternal long axis view) showing the aortic valve mass measuring 2.3 x 1.4 cm (red arrow).
Figure 2
Figure 2. Transesophageal echocardiography (mid-esophageal short axis view) showing the aortic valve mass obstructing the aortic valve orifice, measuring 3.0 x 2.1 cm (red arrow).
Figure 3
Figure 3. Intra-operative view of the aortic valve with a firm brownish mass measuring 3 x 3 x 2 cm protruding from it.
Figure 4
Figure 4. Post-operative transthoracic echocardiogram of aortic valve prosthesis with a mean gradient of 6 mmHg.
Figure 5
Figure 5. Post-operative transthoracic echocardiogram of the mitral valve.
See this image and copyright information in PMC

References

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