title: Aerococcus urinae, a rare cause of infective endocarditis.
abstract: We present the case of an elderly male who was initially seen in our hospital for a urinary tract infection that was treated with oral ciprofloxacin. He was admitted 2 weeks later with altered mental status and fever, and was found to have bacteraemia with Aerococcus urinae Owing to altered mental status a brain MRI was performed which showed evidence of embolic stroke. Following this, a transesophageal echocardiogram showed severe mitral regurgitation and a vegetation >1 cm involving the mitral valve with associated destruction of posterior valve leaflets. The patient was started on antibiotics intravenous penicillin G and intravenous gentamicin for a total duration of 6 weeks. He underwent mitral valve replacement on day 4 of hospitalisation. The postoperative course was complicated by ventilator-dependent respiratory failure, requiring tracheostomy and eventual transfer to a skilled nursing facility. Unfortunately, he died after 2 weeks of stay at the facility.
authors.affiliation: Department of Internal Medicine, Reading Hospital and Medical Center, Reading, Pennsylvania, USA Lebanon, Pennsylvania, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Melnick
authors.affiliation: Reading Hospital and Medical Center, Reading, Pennsylvania, USA.
authors.forename: Salik
authors.initials: S
authors.lastname: Nazir
authors.affiliation: Reading Hospital and Medical Center, Reading, Pennsylvania, USA.
authors.forename: Rittu
authors.initials: R
authors.lastname: Hingorani
authors.affiliation: Reading Hospital and Medical Center, Reading, Pennsylvania, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Wexler
mesh_terms: D056570:Aerococcus; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D017809:Fatal Outcome; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000382:microbiology* / Q000601:surgery; D010406:Penicillins / Q000627:therapeutic use; D020521:Stroke / Q000150:complications; D014552:Urinary Tract Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D010406:Penicillins