Medical Management of Pseudomonas aeruginosa Endocarditis

A therapeutic challenge

Infective endocarditis carries an overall mortality rate varying from 10% - 50%, as well as morbidity due to embolic phenomena, heart failure and other local complications. Infective endocarditis due to gram negative bacilli other than the “HACEK” organisms (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella) are rare, and that due to Pseudomonas aeruginosa constitutes 0.4% of all cases as observed in the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS). It is challenging to diagnose and manage endocarditis due to Pseudomonas aeruginosa, and management may require surgical intervention in addition to medical therapy. Due to the rarity of such cases, no standard treatment regimen exists. We reported a case of P. aeruginosa endocarditis who was managed medically with a 4 weeks therapy of a beta-lactam plus an aminoglycoside and no surgical interventions.

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