Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the Unpredictable

<b>Background:</b> Infective endocarditis is a severe, life-threatening condition which affects the endocardial lining of the heart. Right-sided IE typically affects the tricuspid valve and, less commonly, the pulmonary valve, often in association with intravenous drug use and intracardi...

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Main Authors: Andrei Vâţă, Isabela Ioana Loghin, Radu Ștefan Miftode, Daniela Crişu, Cătălina Mihaela Luca, Alin Mihai Vasilescu, Ioana Maria Onofrei, Tudorița Parângă, Ionela-Larisa Miftode
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/3/220
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author Andrei Vâţă
Isabela Ioana Loghin
Radu Ștefan Miftode
Daniela Crişu
Cătălina Mihaela Luca
Alin Mihai Vasilescu
Ioana Maria Onofrei
Tudorița Parângă
Ionela-Larisa Miftode
author_facet Andrei Vâţă
Isabela Ioana Loghin
Radu Ștefan Miftode
Daniela Crişu
Cătălina Mihaela Luca
Alin Mihai Vasilescu
Ioana Maria Onofrei
Tudorița Parângă
Ionela-Larisa Miftode
author_sort Andrei Vâţă
collection DOAJ
description <b>Background:</b> Infective endocarditis is a severe, life-threatening condition which affects the endocardial lining of the heart. Right-sided IE typically affects the tricuspid valve and, less commonly, the pulmonary valve, often in association with intravenous drug use and intracardiac devices. <i>Enterococcus faecalis</i>, a significant pathogen in healthcare settings, is frequently resistant to several antibiotics, complicating treatment. <b>Results:</b> We present the case of a 69-year-old man diagnosed with isolated pulmonary valve endocarditis, with no identifiable risk factors, good oral hygiene, and no recent dental procedures. In our case, the <i>E. faecalis</i> strain, initially susceptible to ampicillin, acquired resistance during high-dose ampicillin and gentamicin therapy, leading to cardiac surgery and prolonged antibiotic treatment. <b>Conclusions:</b> IPE is rare, emphasizing the need for heightened clinical awareness and thorough diagnostic evaluation, especially in patients with endocarditis symptoms and known risk factors. Although ampicillin resistance in <i>E. faecalis</i> is uncommon, its emergence during treatment presents a challenge, necessitating careful antibiotic stewardship to improve outcomes.
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spelling doaj-art-498e937b68b84f6faeba657d1412614d2025-08-20T02:11:25ZengMDPI AGAntibiotics2079-63822025-02-0114322010.3390/antibiotics14030220Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the UnpredictableAndrei Vâţă0Isabela Ioana Loghin1Radu Ștefan Miftode2Daniela Crişu3Cătălina Mihaela Luca4Alin Mihai Vasilescu5Ioana Maria Onofrei6Tudorița Parângă7Ionela-Larisa Miftode8Department of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Cardiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Cardiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania“St Spiridon” Emergency Hospital, 700115 Iași, RomaniaDepartment of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania<b>Background:</b> Infective endocarditis is a severe, life-threatening condition which affects the endocardial lining of the heart. Right-sided IE typically affects the tricuspid valve and, less commonly, the pulmonary valve, often in association with intravenous drug use and intracardiac devices. <i>Enterococcus faecalis</i>, a significant pathogen in healthcare settings, is frequently resistant to several antibiotics, complicating treatment. <b>Results:</b> We present the case of a 69-year-old man diagnosed with isolated pulmonary valve endocarditis, with no identifiable risk factors, good oral hygiene, and no recent dental procedures. In our case, the <i>E. faecalis</i> strain, initially susceptible to ampicillin, acquired resistance during high-dose ampicillin and gentamicin therapy, leading to cardiac surgery and prolonged antibiotic treatment. <b>Conclusions:</b> IPE is rare, emphasizing the need for heightened clinical awareness and thorough diagnostic evaluation, especially in patients with endocarditis symptoms and known risk factors. Although ampicillin resistance in <i>E. faecalis</i> is uncommon, its emergence during treatment presents a challenge, necessitating careful antibiotic stewardship to improve outcomes.https://www.mdpi.com/2079-6382/14/3/220infective endocarditis<i>Enterococcus faecalis</i>antibiotic resistance
spellingShingle Andrei Vâţă
Isabela Ioana Loghin
Radu Ștefan Miftode
Daniela Crişu
Cătălina Mihaela Luca
Alin Mihai Vasilescu
Ioana Maria Onofrei
Tudorița Parângă
Ionela-Larisa Miftode
Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the Unpredictable
Antibiotics
infective endocarditis
<i>Enterococcus faecalis</i>
antibiotic resistance
title Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the Unpredictable
title_full Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the Unpredictable
title_fullStr Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the Unpredictable
title_full_unstemmed Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the Unpredictable
title_short Isolated Pulmonary Valve Endocarditis Caused by <i>Enterococcus faecalis</i>—Facing the Unpredictable
title_sort isolated pulmonary valve endocarditis caused by i enterococcus faecalis i facing the unpredictable
topic infective endocarditis
<i>Enterococcus faecalis</i>
antibiotic resistance
url https://www.mdpi.com/2079-6382/14/3/220
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