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Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient
BACKGROUND: Bacterial infective endocarditis caused by Proteus mirabilis is rare and there are few cases in the literature. The natural history and treatment of this disease is not as clear but presumed to be associated with complicated urinary tract infection (cUTI). CASE PRESENTATION: A 65-year-ol...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670115/ https://www.ncbi.nlm.nih.gov/pubmed/34906094 http://dx.doi.org/10.1186/s12879-021-06931-w |
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author | Grossman, Lindsay G. Sharkey, Joseph M. Grossman, David S. Hartman, Alan Makaryus, Mina Shah, Kaushal B. |
author_facet | Grossman, Lindsay G. Sharkey, Joseph M. Grossman, David S. Hartman, Alan Makaryus, Mina Shah, Kaushal B. |
author_sort | Grossman, Lindsay G. |
collection | PubMed |
description | BACKGROUND: Bacterial infective endocarditis caused by Proteus mirabilis is rare and there are few cases in the literature. The natural history and treatment of this disease is not as clear but presumed to be associated with complicated urinary tract infection (cUTI). CASE PRESENTATION: A 65-year-old female with a history of rheumatoid arthritis, factor V Leiden hypercoagulability, and prior saddle pulmonary embolism presented to the emergency department following a mechanical fall. Computed Tomography showed evidence of acute/subacute splenic emboli. Complicated UTI was likely secondary to a ureteral stone. Blood and urine cultures also grew out P. mirabilis. Transthoracic echocardiography revealed a mobile echogenic density on the anterior mitral valve (MV) leaflet consistent with a vegetation. The patient underwent MV replacement, and P. mirabilis was isolated from the surgically removed valve. CONCLUSIONS: We hypothesize that the patient’s immunocompromised status following steroid and Janus Kinase inhibitor usage for rheumatoid arthritis contributed to Gram-negative bacteremia following P. mirabilis UTI, ultimately seeding the native MV. Additional studies with larger numbers of Proteus endocarditis cases are needed to investigate an association between immunosuppression and Proteus species endocarditis. |
format | Online Article Text |
id | pubmed-8670115 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86701152021-12-15 Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient Grossman, Lindsay G. Sharkey, Joseph M. Grossman, David S. Hartman, Alan Makaryus, Mina Shah, Kaushal B. BMC Infect Dis Case Report BACKGROUND: Bacterial infective endocarditis caused by Proteus mirabilis is rare and there are few cases in the literature. The natural history and treatment of this disease is not as clear but presumed to be associated with complicated urinary tract infection (cUTI). CASE PRESENTATION: A 65-year-old female with a history of rheumatoid arthritis, factor V Leiden hypercoagulability, and prior saddle pulmonary embolism presented to the emergency department following a mechanical fall. Computed Tomography showed evidence of acute/subacute splenic emboli. Complicated UTI was likely secondary to a ureteral stone. Blood and urine cultures also grew out P. mirabilis. Transthoracic echocardiography revealed a mobile echogenic density on the anterior mitral valve (MV) leaflet consistent with a vegetation. The patient underwent MV replacement, and P. mirabilis was isolated from the surgically removed valve. CONCLUSIONS: We hypothesize that the patient’s immunocompromised status following steroid and Janus Kinase inhibitor usage for rheumatoid arthritis contributed to Gram-negative bacteremia following P. mirabilis UTI, ultimately seeding the native MV. Additional studies with larger numbers of Proteus endocarditis cases are needed to investigate an association between immunosuppression and Proteus species endocarditis. BioMed Central 2021-12-14 /pmc/articles/PMC8670115/ /pubmed/34906094 http://dx.doi.org/10.1186/s12879-021-06931-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Grossman, Lindsay G. Sharkey, Joseph M. Grossman, David S. Hartman, Alan Makaryus, Mina Shah, Kaushal B. Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient |
title | Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient |
title_full | Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient |
title_fullStr | Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient |
title_full_unstemmed | Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient |
title_short | Rare case of Proteus mirabilis native mitral valve endocarditis in an immunocompromised patient |
title_sort | rare case of proteus mirabilis native mitral valve endocarditis in an immunocompromised patient |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670115/ https://www.ncbi.nlm.nih.gov/pubmed/34906094 http://dx.doi.org/10.1186/s12879-021-06931-w |
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