Objective:

To report a case of Curtobacterium oceansedimentum infective endocarditis (IE) associated with severe aortic valve dysfunction and acute heart failure.

Approach:

• Case presentation: A 53-year-old man presented with dyspnea, edema, and cardiogenic shock associated with severe aortic insufficiency and left coronary cusp perforation.
• Microbiological diagnosis: Blood cultures remained negative. Culture of the excised valve grew gram-positive rods; an outside laboratory identified the organism as C. oceansedimentum.
• Treatment and follow-up: The patient underwent bioprosthetic aortic valve replacement and received antibiotics. He later returned with acute heart failure and a markedly reduced ejection fraction; the prosthetic valve functioned normally and no vegetation was seen.

Key Findings:

• The authors report what they describe, to their knowledge, as the first case of Curtobacterium infective endocarditis.
• The patient presented with severe aortic insufficiency, left coronary cusp perforation, and cardiogenic shock.
• Blood cultures remained negative; culture of excised valve tissue enabled identification of Curtobacterium oceansedimentum at an outside laboratory.
• The patient left rehabilitation against medical advice before completing the prescribed antibiotic course. Four weeks later, he was readmitted with acute heart failure; echocardiography showed a normally functioning bioprosthetic valve and no vegetation.

Interpretation:

The report documents C. oceansedimentum as a cause of IE and describes invasive valvular infection despite negative blood cultures. The authors note that the route of infection in this patient could not be established.

Limitations:

• This is a single case report.
• The route of infection could not be established.
• The patient left rehabilitation against medical advice before completing the initial prescribed antibiotic course.

Conclusion:

The authors state that this case broadens the differential diagnosis for culture-negative IE, particularly in patients with relevant exposure histories.

Sources:

• Article context provided by the user