Pseudomonas aeruginosa septicemia resulting in coronary stent infection and coronary artery aneurysm and acute infective endocarditis of mitral valve causing severe mitral regurgitation- A case report

Abstract

Infectious complications following cardiac catheterizations, percutaneous cardiac interventions and device implantations are known but are not very common. Inadequate aseptic precautions, pre-existing infection, volume of cases, and complexity of cases warranting long procedures may contribute to the incidence of such complications. We report an unusual case of Pseudomonas aeruginosa septicemia following percutaneous coronary intervention causing concomitant infection of coronary stent and mitral valve resulting in coronary artery aneurysm and severe mitral regurgitation, respectively. Pseudomonas infective endocarditis involving the right-sided cardiac valves occurs predominantly in intravenous drug abusers and immunocompromised hosts. Majority of cases of left-sided P. aeruginosa endocarditis are acquired in the hospital and result in fatal outcomes. So, no effort should be spared to prevent infections during invasive cardiac procedures. Optimal treatment depends on sensitivity of the organism to a particular antibiotic, however, combination therapy with anti-pseudomonal beta-lactams or carbapenems and aminoglycosides would be preferable. Majority of patients require surgical removal of stent and prolonged suitable intravenous antibiotic therapy.

Keywords

• Infective endocarditis
• Pseudomonas aeruginosa
• Percutaneous cardiac interventions
• Coronary artery aneurysm
• Bacteremia
• Acute anterior ST elevation myocardial infarction