Late prosthetic valve endocarditis with Mycobacterium tuberculosis after the Bentall procedure

Qianqian Liu,
Jialin Jin,
Lingyun Shao,
Shanshan Weng,
Ju Zhou,
Feng Li,
Wenhong Zhang,
Xinhua Weng and
Yan GaoEmail author

Annals of Clinical Microbiology and Antimicrobials201918:15

https://doi.org/10.1186/s12941-019-0314-0

Received: 24 December 2018
Accepted: 19 March 2019
Published: 28 March 2019

Abstract

Background

Prosthetic valve endocarditis (PVE) is a rare but severe complication of valve replacement surgery, with an incidence rate of 0.3–1.2% per patient-year. At present, staphylococci are the predominant causative microorganism of PVE. Herein, we report a confirmed case of late PVE in a mechanical aortic valve caused by Mycobacterium tuberculosis.

Case presentation

A 32-year-old immunocompetent man with recurrent fever and 5-kg weight loss had a history of having undergone the Bentall procedure due to congenital heart disease. Nine years after the operation, he developed a paravalvular abscess in the mechanical aortic valve, presented with evidence of pulmonary tuberculosis on CT scan and was diagnosed with tuberculous endocarditis. This case report highlights a rare and non-negligible example of tuberculous endocarditis involving a mechanical valve.

Conclusions

Tuberculous PVE should be considered in patients with a history of valve replacement, recurrent fever, unexplained weight loss, pulmonary tuberculosis and meaningful valvular findings on echocardiogram.