SHM Converge Scientific Abstract ePoster Gallery-From the Prostate to the Heart: A Rare Case of Escherichia Coli Endocarditis

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This poster describes a rare case of <strong>Escherichia coli infective endocarditis (IE)</strong> in a 74-year-old man with multiple comorbidities, including chronic lymphocytic leukemia, renal cell carcinoma, chronic steroid use, benign prostatic hyperplasia, and coronary artery disease. He developed <strong>fever and shaking chills one week after a prostate biopsy</strong>, with no urinary or abdominal symptoms.

On evaluation, he had <strong>leukocytosis, fever, tachycardia, elevated creatinine, and pyuria</strong>. Blood cultures grew <strong>E. coli in two sets</strong>, and echocardiography revealed a <strong>small semi-mobile mass on the aortic valve</strong>, which was confirmed by transesophageal echocardiogram as infective endocarditis. Imaging also showed a <strong>non-obstructing left kidney stone</strong> and chronic lung changes.

He was treated initially with <strong>ceftriaxone</strong>, and after cultures cleared, was discharged on <strong>ceftriaxone plus ciprofloxacin</strong>. An aminoglycoside was avoided because of <strong>impaired renal function</strong>. The clinicians believed the infection was likely acquired after the prostate biopsy.

The discussion emphasizes that <strong>E. coli is a very rare cause of endocarditis</strong>, despite being a common cause of gram-negative bacteremia. Risk factors include <strong>older age, urinary tract infection, diabetes, and prosthetic valves</strong>. Native valve involvement is less common, but the <strong>aortic valve</strong> is a known site when E. coli IE occurs. Because this condition has <strong>high morbidity and mortality</strong>, early echocardiography should be considered in selected patients with E. coli bacteremia, especially when risk factors or possible urinary-source infection are present.

The main conclusion is that clinicians should not assume E. coli bacteremia is benign in high-risk patients; <strong>early recognition of endocarditis may improve management and outcomes</strong>.

Asset Subtitle

Fadi Samaan

Meta Tag

Author List Fadi Samaan, Hadeel Zainah

Category Clinical Vignettes

Concept Escherichia coli

Concept Infective Endocarditis

Concept Bacteremia

Concept Echocardiography

Concept Vegetation

Distinguished Non-Finalist

Presenter Organization Lifespan

Presenting Author Fadi Samaan

Track Adult

Keywords

Escherichia coli

infective endocarditis

aortic valve

prostate biopsy

bacteremia

echocardiography

ceftriaxone

pyuria

renal impairment

gram-negative infection

Escherichia coli

Infective Endocarditis

Bacteremia

Echocardiography

Vegetation