Providencia stuartii Aortic Prosthetic Valve Endocarditis with Formation of Paravalvular Pseudoaneurysm | Insight Medical Publishing

Infective endocarditis (IE) is characterized by high morbidity and mortality. Providencia stuartii infections are very rare and mainly acquired in a hospital setting, being isolated primarily in urine cultures of patients with longterm urinary catheters; rarely causing bacteremia and endocarditis. The authors present a case of a 74-year-old male patient with vascular risk factors and a biological aortic prosthetic valve hospitalized for urosepsis with P. stuartii bacteremia. He underwent antibiotic susceptibility-guided therapy, resulting in both negative urine and blood cultures. However, the patient was later re-admitted due to persistent P. stuartii urosepsis and bacteremia. A transesophageal echocardiogram revealed endocarditis of the prosthetic aortic valve, complicated with extensive aortic root pseudoaneurysm, fistulized into the left atrium. Given the co-comorbidities and extent of the disease, he was not a candidate for surgical intervention and therefore maintained broad-spectrum antibiotic therapy. Unfortunately, the patient didn’t respond to best medical treatment and died of septic shock.