SHM Converge Scientific Abstract ePoster Gallery-Aerococcus Urinae Infection Leading to Fatal Acute Valvular Dysfunction

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This case report describes a fatal infection caused by <em>Aerococcus urinae</em>, an uncommon gram-positive pathogen often mistaken for other cocci and usually associated with urinary tract infections. In rare cases, it can cause bacteremia and infective endocarditis, likely related to its ability to form biofilms and promote platelet aggregation.

A 63-year-old man with hypertension and a history of abdominal aortic aneurysm repair presented with three weeks of generalized weakness and three days of fever. On exam, he had tachycardia, a systolic murmur, crackles in the lungs, abdominal distension, and bilateral leg edema. Initial labs showed leukocytosis, metabolic acidosis, elevated BNP, and acute kidney injury.

He was started on broad-spectrum antibiotics, which were later narrowed to penicillin after blood cultures grew <em>Aerococcus</em>. Because bacteremia persisted, transthoracic echocardiography was performed and showed findings concerning for infective endocarditis, including mitral and aortic valve thickening and regurgitation. The patient developed acute valvular dysfunction with severe regurgitation, leading to cardiogenic shock and death despite resuscitation efforts.

The key message is that persistent <em>Aerococcus urinae</em> bacteremia should prompt concern for infective endocarditis. Although uncommon, this organism can cause serious cardiac complications such as valvular dysfunction, heart failure, embolization, conduction abnormalities, and death. Early recognition, appropriate antibiotics, and timely surgical or procedural intervention may help prevent fatal outcomes.

Asset Subtitle

Shristi Nepal

Meta Tag

Author List Jason Sniffen, Shristi Nepal

Category Clinical Vignettes

Concept Aerococcus urinae

Concept Infective Endocarditis

Concept Bacteremia

Concept Antibiotic Therapy

Concept Cardiac Evaluation

Distinguished Non-Finalist

Presenter Organization Hartford Hospital

Presenting Author Shristi Nepal

Track Adult

Keywords

Aerococcus urinae

bacteremia

infective endocarditis

gram-positive pathogen

urinary tract infection

biofilm formation

platelet aggregation

valvular dysfunction

cardiogenic shock

fatal infection

Aerococcus urinae

Infective Endocarditis

Bacteremia

Antibiotic Therapy

Cardiac Evaluation