SHM Converge Scientific Abstract ePoster Gallery-Eat Your Heart Out: A Rare Case of Infective Endocarditis Cause by Escherichia Coli in an Immunocompetent Patient

Eat Your Heart Out: A Rare Case of Infective Endocarditis Cause by Escherichia Coli in an Immunocompetent Patient

Pdf Summary

Escherichia coli infective endocarditis (IE) is a rare but serious form of IE, accounting for about 1% of cases. More broadly, gram-negative IE represents 5–10% of community-acquired IE and is usually caused by HACEK organisms, while E. coli is an uncommon cause with fewer than 40 reported cases in the literature. Despite its rarity, E. coli IE has substantial risk: the reported mortality rate is about 21%, higher than the 5% mortality seen with HACEK IE. Surgical intervention is needed in roughly 42% of E. coli IE cases.<br /><br />IE overall is associated with high morbidity and mortality, with a six-month mortality of about 25%. A major challenge is delayed diagnosis. More than 90% of patients with non-HACEK gram-negative endocarditis are diagnosed more than one month after symptom onset. Because of this, clinicians should maintain a high index of suspicion for E. coli endocarditis when blood cultures are positive but the patient fails to improve clinically.<br /><br />The poster highlights diagnostic imaging from a case showing multiple septic emboli on brain MRI and a 1.4 cm mitral valve vegetation on transesophageal echocardiography (TEE). The authors emphasize that timely recognition and evaluation are essential to avoid treatment delays and improve outcomes.

Asset Subtitle

Madison L. Paul

Meta Tag

Author List Kathleen O'Leary, Madison L. Paul

Category Clinical Vignettes

Concept Escherichia coli

Concept Infective Endocarditis

Concept Mortality

Concept Transesophageal Echocardiography

Concept Vegetation

Distinguished Non-Finalist

Presenter Organization Madigan Family Medicine Residency/Joint Base Lewis McChord/Us Army

Presenting Author Madison L. Paul

Track Adult

Keywords

Escherichia coli

infective endocarditis

gram-negative endocarditis

HACEK organisms

mortality rate

surgical intervention

blood cultures

delayed diagnosis

septic emboli

transesophageal echocardiography

Escherichia coli

Infective Endocarditis

Mortality

Transesophageal Echocardiography

Vegetation