Endocarditis due to Abiotrophia defectiva, a biofilm-related infection associated with the presence of fixed braces: A case report

Abstract

Rationale: Endocarditis with Abiotrophia defectiva represents 4.3% to 6% of all streptococcal endocarditis. The article presents diagnosis issues and the complexity of the treatment. Patient concerns: We present the case of a female white patient, aged 26 years, who developed infectious endocarditis caused by A defectiva, in the last trimester of pregnancy, a biofilm-related infection associated with the presence of fixed braces. Diagnoses: The diagnosis of infectious endocarditis was confirmed by the cardiac ultrasound examination that revealed a voluminous vegetation on the mitral valve, and acute mitral regurgitation caused by chordae tendinae rupture, and also by isolating Abiotrophia defectiva from two positive blood cultures. Interventions: The decision to undergo surgical intervention was taken, and a mitral valve replacement was performed. Surgical intervention that was associated with board-spectrum antibiotic therapy. Outcomes: A defectiva, remains a rare cause of infective endocarditis, with a reserved prognosis that is motivated by the extensive valvular lesions and the risk of embolism. Lessons: The use of antibiotics administered in association, in the management of infective endocarditis, is mandatory. Abbreviations: AMVL = anterior mitral valve leaf, AV block = atrioventricular block, BHS = beta-hemolytic streptococci, EF = ejection fraction, EPSs = extracellular polymeric substances, GDH EIA = glutamate dehydrogenase enzyme immunoassay, MICs = minimum inhibitory concentrations, NVS = nutritionally variant Streptococci, PASP = pulmonary artery systolic pressure, PM = posteromedial papillary muscle.