From Ileum to Endocardium - A Case Report of Yersinia pseudotuberculosis prosthetic valve infective Endocarditis

Abstract Background We report a case of Yersinia pseudotuberculosis prosthetic valve infective endocarditis (IE) in a 70-year old female. To date, Y. pseudotuberculosis IE has not been described in the literature. Case Summary The patient presented with sepsis and a history of acute gastroenteritis, on a background of a long-standing mechanical mitral-valve replacement (MVR) for rheumatic valve disease. Initial blood cultures grew Y. pseudotuberculosis, and a trans-oesophageal echocardiogram (TOE) demonstrated a mobile lesion suggestive of vegetations on the atrial surface of the MVR. Appropriate intra-venous antibiotics were commenced with an improvement in both her serum markers and clinical status. The patient made a full clinical recovery and follow up imaging showed complete resolution of valvular lesions. Discussion In the setting of acute gastroenteritis among patients with prosthetic valves, clinicians must be vigilant for unusual gastro-intestinal organisms as a cause for infective endocarditis.