Successful Management of Infective Endocarditis Involving Double Native Valves after TUR-P: A Case Report

Abstract

Aims: Infective endocarditis (IE) is an uncommon, yet potentially fatal disease characterized by infection of the endocardial surface, frequently affecting heart valves. Surgical interventions involving the urinary system can lead to temporary bacteraemia, which is crucial for the development of infective endocarditis. This report presents a case of double valve infective endocarditis in a diabetic patient subsequent to transurethral prostate removal, which was successfully addressed through surgical intervention. Presentation of Case:  A 65-year-old male patient with a history of hypertension and diabetes presented with new-onset heart failure and low-grade fever one month following transurethral resection of the prostate (TURP). Physical examination indicated signs of congestion and the presence of systolic and diastolic murmurs. Echocardiography demonstrated significant vegetations on the mitral and aortic valves, accompanied by severe regurgitation. Empirical antibiotic therapy was commenced; however, multiple blood cultures yielded negative results. The patient underwent concurrent mitral and aortic valve replacement along with coronary artery bypass grafting (CABG) due to symptoms of heart failure and the risk of embolism. Histological examination and culture of the valve revealed Staphylococcus warneri as the causative microorganism. The patient was subsequently discharged successfully. Discussion and Conclusion: Managing IE to prevent and treat consequences including embolism and heart failure depends critically on parenteral antibiotics and quick surgical intervention. Staphylococcus warneri is low virulent, but it can be invasive in sensitive people, which emphasizes the significance of early identification and treatment.