Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistance

Infective endocarditis (IE) caused by gram-negative microorganisms, particularly Pseudomonas aeruginosa, is a rare but serious condition. This case report details a 76-year-old male who presented with fever and mild urinary symptoms following a recent bacteremia treated with ciprofloxacin. Initial e...

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Main Authors: Marc Pedrosa Aragón, Armand Sellas Farres, Sonia Calzado Isbert, Mateu Espasa-Soley
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214250925000861
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author Marc Pedrosa Aragón
Armand Sellas Farres
Sonia Calzado Isbert
Mateu Espasa-Soley
author_facet Marc Pedrosa Aragón
Armand Sellas Farres
Sonia Calzado Isbert
Mateu Espasa-Soley
author_sort Marc Pedrosa Aragón
collection DOAJ
description Infective endocarditis (IE) caused by gram-negative microorganisms, particularly Pseudomonas aeruginosa, is a rare but serious condition. This case report details a 76-year-old male who presented with fever and mild urinary symptoms following a recent bacteremia treated with ciprofloxacin. Initial evaluation revealed positive blood cultures for multi-susceptible P. aeruginosa and an abdominal abscess. Despite a favorable initial response to treatment, the patient developed a cerebral infarction due to a septic embolism. Subsequent cultures revealed resistance to piperacillin/tazobactam and ceftazidime, prompting escalation of antibiotic therapy. A transesophageal echocardiogram confirmed infective endocarditis with a vegetative mass on the aortic valve. The patient underwent surgical intervention, with positive cultures from the valve confirming the resistant strain. Following six weeks of targeted antibiotic therapy, he remained asymptomatic for over a year. This case underscores the importance of monitoring for endocarditis in patients with P. aeruginosa bacteremia and highlights the challenges posed by emerging antibiotic resistance.
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series IDCases
spelling doaj-art-e3288946e8f34e0cae6c17a3b3828a762025-08-20T03:11:04ZengElsevierIDCases2214-25092025-01-0140e0223110.1016/j.idcr.2025.e02231Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistanceMarc Pedrosa Aragón0Armand Sellas Farres1Sonia Calzado Isbert2Mateu Espasa-Soley3Infectous Diseases Department. Corporació Sanitaria Parc Taulí Sabadell, Parc del Taulí, 1, Barcelona, Sabadell 08208, Spain; Corresponding author.Intensive Care Unit. Corporació Sanitaria Parc Taulí, Sabadell. Parc del Taulí, 1, Barcelona, Sabadell 08208, SpainIntensive Care Unit. Corporació Sanitaria Parc Taulí, Sabadell. Parc del Taulí, 1, Barcelona, Sabadell 08208, SpainMicrobiology Department. Hospital Clínic de Barcelona, Carrer de Villarroel 170, Barcelona 08036, SpainInfective endocarditis (IE) caused by gram-negative microorganisms, particularly Pseudomonas aeruginosa, is a rare but serious condition. This case report details a 76-year-old male who presented with fever and mild urinary symptoms following a recent bacteremia treated with ciprofloxacin. Initial evaluation revealed positive blood cultures for multi-susceptible P. aeruginosa and an abdominal abscess. Despite a favorable initial response to treatment, the patient developed a cerebral infarction due to a septic embolism. Subsequent cultures revealed resistance to piperacillin/tazobactam and ceftazidime, prompting escalation of antibiotic therapy. A transesophageal echocardiogram confirmed infective endocarditis with a vegetative mass on the aortic valve. The patient underwent surgical intervention, with positive cultures from the valve confirming the resistant strain. Following six weeks of targeted antibiotic therapy, he remained asymptomatic for over a year. This case underscores the importance of monitoring for endocarditis in patients with P. aeruginosa bacteremia and highlights the challenges posed by emerging antibiotic resistance.http://www.sciencedirect.com/science/article/pii/S2214250925000861EndocarditisBacteremiaPseudomonasAntibiotic resistance
spellingShingle Marc Pedrosa Aragón
Armand Sellas Farres
Sonia Calzado Isbert
Mateu Espasa-Soley
Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistance
IDCases
Endocarditis
Bacteremia
Pseudomonas
Antibiotic resistance
title Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistance
title_full Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistance
title_fullStr Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistance
title_full_unstemmed Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistance
title_short Challenging infective endocarditis: A case of Pseudomonas aeruginosa with emergent antibiotic resistance
title_sort challenging infective endocarditis a case of pseudomonas aeruginosa with emergent antibiotic resistance
topic Endocarditis
Bacteremia
Pseudomonas
Antibiotic resistance
url http://www.sciencedirect.com/science/article/pii/S2214250925000861
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AT soniacalzadoisbert challenginginfectiveendocarditisacaseofpseudomonasaeruginosawithemergentantibioticresistance
AT mateuespasasoley challenginginfectiveendocarditisacaseofpseudomonasaeruginosawithemergentantibioticresistance