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A Unique Case of Burkholderia cepacia Prosthetic Mitral Valve Endocarditis and Literature Review

Dellalana, Laura E., BS*; Byrge, Kelly C., MD; Gandelman, Jocelyn S., BS*; Lines, Tara, PharmD; Aronoff, David M., MD; Person, Anna K., MD

Infectious Diseases in Clinical Practice: May 2019 - Volume 27 - Issue 3 - p 123–125
doi: 10.1097/IPC.0000000000000708
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Burkholderia cepacia prosthetic valve endocarditis (PVE) is extremely rare, with few cases in the literature. A report of a patient with PVE is described, followed by a literature review on B. cepacia PVE. A 38-year-old man with poor dentition and a history of intravenous drug use and mitral valve replacement was found to have a mitral valve vegetation. Five sets of blood cultures on different days grew B. cepacia. Individual sets of blood cultures on different dates also isolated Streptococcus viridans (outside hospital culture), methicillin-resistant Staphylococcus epidermidis (hospital day 1), and Bacillus spp. (hospital day 6). He was successfully treated with ceftazidime and levofloxacin as dual therapy for B. cepacia PVE, in addition to vancomycin for gram-positive coverage. This case report and review highlights the possibility of B. cepacia PVE in immunocompetent patients with poor dentition, with the potential for a successful outcome after combination antimicrobial therapy.

From the *Vanderbilt School of Medicine;

Division of Infectious Diseases, Department of Medicine; and

Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN.

Correspondence to: Anna K. Person, MD, Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, 116 21st Ave S, Medical Center North, Nashville, TN, 37232. E-mail: anna.k.person@vumc.org.

D.M.A. is supported by National Institutes of Health grant AI134036.

The authors have no conflicts of interest to disclose.

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