Achromobacter xylosoxidans Subspecies denitrificans Endocarditis in a Patient with Prosthetic Aortic Valve: A Case Report and Review of Literature

Abstract

Achromobacter xylosoxidans subspecies denitrificans flourishes in presence of oxygen, commonly isolated from aquatic milieu. It is rarely implicated as the causative agent of endocarditis. It is not known to cause virulent infections in patients but causes severe infections in immunosuppressed patients with underlying co-morbidities. Present report is first case of Achromobacter xylosoxidans prosthetic valve endocarditis from India. This case report is of a 47-year-old male, suffering from Rheumatic Heart Disease (RHD), who presented to the cardiology emergency with a chief complaints of remitting type high-grade fever for two years followed by persistent fever for 10 days. On echocardiography and positively flagged BACTEC blood culture reports, it was diagnosed as a case of Achromobacter xylosoxidans subspecies denitrificans bacteraemia and prosthetic aortic valve endocarditis. Antibiotics were started according to the susceptibility testing but the patient could not complete the course of treatment as he developed dyspnoea and cardiac arrest following which he could not be resuscitated.

Keywords

• aortic regurgitation
• endocarditis
• immunocompromised patients
• matrix-assisted laser desorption/ionisation-time of flight-mass spectrometry
• mitral regurgitation
• rheumatic heart disease