Klebsiella oxytoca tricuspid valve endocarditis in an elderly patient without known predisposing factors

BMJ Case Reports
Waqas MemonZonaira Shabbir

Abstract

A 73-year-old man with history of nephrolithiasis was admitted after a witnessed cardiac arrest. In the emergency department, the patient had several runs of ventricular fibrillation treated with defibrillation and amiodarone infusion. Echocardiography revealed reduced ejection fraction with multiple mobile structures attached to the tricuspid valve leaflets. Due to concern for possible endocarditis, the patient was started on broad-spectrum antibiotics. On the following day, a renal ultrasound was performed for acute kidney injury followed by a non-contrast CT scan that revealed an obstructing 21 mm left-sided ureteral stone with pyohydronephrosis. He underwent emergent nephrostomy tube placement. Blood and urine cultures subsequently demonstrated the growth of Klebsiella oxytoca A follow-up transoesophageal echocardiogram confirmed multiple mobile, hyperechoic masses consistent with vegetations. The suspected source for the endocarditis was from the pyelonephritis. The patient's clinical condition improved after a course of intravenous antibiotics and was discharged on oral antibiotics.

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Citations

Mar 4, 2021·Current Microbiology·Nakul NeogPankaj Chetia
Feb 20, 2021·Journal of Chemotherapy·Petros IoannouDiamantis P Kofteridis
Apr 27, 2021·The Angle Orthodontist·Bruno Andrade PellissariVictor Angelo Martins Montalli
Dec 2, 2021·Clinical Microbiology Reviews·Jing YangZhiyong Zong

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