Recurrent Klebsiella Pneumoniae Infection Causing Transcatheter Aortic Valve Implantation (TAVI)-Related Endocarditis
| Autor: | Cristiano Silva Cruz, Torcato Moreira Marques, Teresa Ferreira, Valentina Tosatto, Matteo Boattini, Rita Barata Moura, André M. Almeida |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Klebsiella bacteraemia Klebsiella pneumoniae HSM MED Transcatheter Aortic Valve Implantation Urinary system Periprosthetic lcsh:Medicine 030204 cardiovascular system & hematology Klebsiella Pneumoniae Infective Endocarditis 03 medical and health sciences 0302 clinical medicine Internal Medicine medicine Endocarditis 030212 general & internal medicine Abscess transcatheter aortic valve implantation biology business.industry infective endocarditis lcsh:R Articles medicine.disease biology.organism_classification Surgery klebsiella pneumoniae Stenosis Infective endocarditis Bacteraemia business |
| Zdroj: | European Journal of Case Reports in Internal Medicine (2020) Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP European Journal of Case Reports in Internal Medicine |
| Popis: | The authors report the case of an 86-year-old woman presenting with recurrent Klebsiella pneumoniae bacteraemia. She had severe aortic stenosis submitted to a recent transcatheter aortic valve implantation (TAVI). Initially, Klebsiella pneumoniae bacteraemia from a urinary source was diagnosed. Following another 4 episodes of bacteraemia with the same agent, the source was ultimately found to be a periprosthetic abscess. Considering the patient’s unsuitability for surgery, a decision was made for life-long antimicrobial therapy. This approach has been successful in preventing recurrences or complications. Endocarditis is one of the most severe complications seen following TAVI, often carrying a poor prognosis. Even though Klebsiella spp. are common pathogens for healthcare-associated infections among the elderly, they are seldom the causative agent for endocarditis. Being the first reported case of TAVI-related Klebsiella endocarditis, it was successfully managed using a medical approach. LEARNING POINTS Non-HACEK Gram-negative bacilli are organisms infrequently found to cause infective endocarditis (IE). This is the first reported case of transcatheter aortic valve implantation (TAVI)-related Klebsiella IE. Diagnosing an infectious complication associated with procedural or prosthetic material is not always straightforward; a high level of suspicion and a systematic approach are essential. Most cases of TAVI-related IE are ineligible for surgery due to a prohibitive procedural risk. Long-term antibiotic therapy may be a suitable alternative for patients with uncontrolled infection considered unfit for surgery. |
| Databáze: | OpenAIRE |
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