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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Native valve infective endocarditis due to ampicillin-resistant Escherichia coli...
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Vol. 67. Issue 2.
Pages 103-107 (February 2020)
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Vol. 67. Issue 2.
Pages 103-107 (February 2020)
Case report
Native valve infective endocarditis due to ampicillin-resistant Escherichia coli in the postoperative period of a right radical nephrectomy due to xanthogranulomatous pyelonephritis
Endocarditis infecciosa sobre válvula nativa por Escherichia coli resistente a ampicilina en el postoperatorio de una nefrectomía radical derecha por pielonefritis xantogranulomatosa
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B. Esnaola Iriarte
Corresponding author
beaesnaola@gmail.com

Corresponding author.
, S. Telletxea Benguria, K. Intxaurraga Fernández, E. Díez Castillo
Servicio de Anestesiología, Reanimación y Tratamiento del dolor, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
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Abstract

Infective endocarditis (IE) due to Escherichia coli is a rare disease, although increasingly frequent. Persistent fever in septic patients despite adequate treatment raises the need to consider IE as a differential diagnosis. We present the case of a 36-year-old male patient who underwent a radical right nephrectomy as a result of diagnosis of xanthogranulomatous pyelonephritis, presenting in the postoperative period a state of septic shock with persistent fever of 41 °C. Given the finding of a new-onset murmur, he was diagnosed with a mitroaortic IE by means of a transesophageal echocardiogram (TEE), having to undergo cardiac surgery for valve replacement. After multiple postoperative complications, he is successfully discharged.

Keywords:
Postoperative infective endocarditis
Escherichia coli
Urologic sepsis
Resumen

La endocarditis infecciosa (EI) debida a Escherichia coli es una enfermedad rara, aunque cada vez más frecuente. La fiebre persistente en pacientes sépticos a pesar de un tratamiento adecuado plantea la necesidad de considerar la EI como diagnostico diferencial. Presentamos el caso de un paciente varón de 36 años al que se le practica una nefrectomía radical derecha por diagnóstico de pielonefritis xantogranulomatosa, presentando en el postoperatorio un estado de shock séptico con fiebre persistente de hasta 41 °C. Ante el hallazgo de un soplo de nueva aparición se le diagnostica de EI mitroaórtica mediante Ecocardiograma transesofágico (ETE) teniendo que someterse a cirugía cardiaca para sustitución valvular. Tras múltiples complicaciones postoperatorias es dado de alta exitosamente.

Palabras clave:
Endocarditis infecciosa postoperatoria
Escherichia coli
Sepsis urológica

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