title: Infectious endocarditis caused by Escherichia coli.
abstract: Although Escherichia coli is among the most common causes of Gram-negative bacteraemia, infectious endocarditis (IE) due to this pathogen is rare. A 67-y-old male without a previous medical history presented with a new mitral regurgitation murmur and persisting E. coli bacteraemia in spite of broad-spectrum intravenous antibiotics. Transthoracic and transoesophageal echocardiography revealed a severe mitral endocarditis. E. coli DNA was identified from the mitral valve and the vegetation, and no other pathogen was found. The case was further complicated by spondylodiscitis and bilateral endophthalmitis. Extra-intestinal pathogenic E. coli (ExPEC) are able to colonize tissue outside the gastrointestinal tract and contain a variety of virulence factors that may enable the pathogens to invade and induce infections in the cardiac endothelia. In these cases echocardiography as the imaging technology is of paramount importance for the correct diagnosis and treatment.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark. trineklauridsen@gmail.com
authors.forename: Trine Kiilerich
authors.initials: TK
authors.lastname: Lauridsen
authors.forename: Magnus
authors.initials: M
authors.lastname: Arpi
authors.forename: Thomas
authors.initials: T
authors.lastname: Fritz-Hansen
authors.forename: Niels
authors.initials: N
authors.lastname: Frimodt-Møller
authors.forename: Niels Eske
authors.initials: NE
authors.lastname: Bruun
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D015299:Discitis / Q000150:complications / Q000175:diagnosis; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D009877:Endophthalmitis / Q000150:complications / Q000175:diagnosis; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008943:Mitral Valve / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents