# Enterococcus faecalis Endocarditis of All Four Native Valves: A Case Report

## TL;DR

This case report describes a rare instance of Enterococcus faecalis infecting all four heart valves in an elderly woman, leading to severe complications and death.

## Contribution

The novelty lies in documenting a rare case of quadruple valve endocarditis caused by Enterococcus faecalis.

## Key findings

- The patient had endocarditis of all four native heart valves due to Enterococcus faecalis.
- The infection was complicated by bacteremia, epidural abscess, discitis, and splenic infarction.
- Despite aggressive treatment, the patient's condition was fatal.

## Abstract

Enterococcus faecalis is commonly implicated in Infective Endocarditis (IE), resulting in remarkable morbidity and mortality. We present an unusual case documenting the clinical course and outcome of an elderly female patient who developed quadruple valve endocarditis due to Enterococcus faecalis infection. She presented with altered mental status, resulting in hospitalization, and was found to have bacteremia complicated by endocarditis, epidural abscess, discitis, and splenic infarction. Urinalysis was consistent with bacterial infection two days before being admitted to the hospital. Unfortunately, despite aggressive therapeutic regimens, the patient died.

This is one of the few documented endocarditis cases involving all heart valves. It reviews the importance of maintaining a high index of clinical suspicion for assessing IE, with a low threshold for performing a transesophageal echocardiogram as a diagnostic tool.