Infective endocarditis due to methicillin-sensitive Staphylococcus aureus in a patient with untreated atopic dermatitis who was successfully treated without surgery

Abstract

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases and Staphylococcus aureus has been frequently isolated from patients with AD. Infective endocarditis (IE) caused by S. aureus is one of the most serious complications of AD. A 46-year-old Japanese woman was admitted to the hospital due to persistent fever. She had untreated AD, and methicillin-sensitive S. aureus was isolated from blood and skin smear cultures. Echocardiography revealed a large mobile vegetation adhered near the annulus of the posterior mitral leaflet; it was diagnosed as AD-associated IE. Although surgical intervention was considered, the patient refused surgery. She was successfully treated with antibiotic therapy only, and resolution of the vegetation was confirmed on follow-up transesophageal echocardiography on Day 42. AD should be considered a predisposing factor of IE and appropriate skin treatment is essential to prevent IE in patients with AD.