European Journal of Case Reports in Internal Medicine (Feb 2020)

Recurrent Klebsiella pneumoniae Infection Causing Transcatheter Aortic Valve Implantation (TAVI)-Related Endocarditis

  • Valentina Tosatto,
  • Cristiano Cruz,
  • Teresa Ferreira,
  • Torcato Moreira Marques,
  • Matteo Boattini,
  • André Almeida,
  • Rita Barata Moura

DOI
https://doi.org/10.12890/2020_001379

Abstract

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The authors report the case of an 86-year-old woman presenting with recurrent Klebsiella pneumoniae bacteraemia. She had severe aortic stenosis submitted to a recent transcatheter aortic valve implantation (TAVI). Initially, Klebsiella pneumoniae bacteraemia from a urinary source was diagnosed . Following another 4 episodes of bacteraemia with the same agent, the source was ultimately found to be a periprosthetic abscess. Considering the patient’s unsuitability for surgery, a decision was made for life-long antimicrobial therapy. This approach has been successful in preventing recurrences or complications. Endocarditis is one of the most severe complications seen following TAVI, often carrying a poor prognosis. Even though Klebsiella spp. are common pathogens for healthcare-associated infections among the elderly, they are seldom the causative agent for endocarditis. Being the first reported case of TAVI-related Klebsiella endocarditis, it was successfully managed using a medical approach.

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