# A Case Report of Salmonella sp. Endocarditis and Literature Review

## TL;DR

This paper reports a rare case of Salmonella endocarditis in an elderly man and reviews other cases from 2014 to 2023, highlighting treatment approaches and outcomes.

## Contribution

The paper adds a new clinical case and provides an updated literature review on Salmonella-induced endocarditis over the last decade.

## Key findings

- Salmonella endocarditis commonly affects aortic and mitral valves, with a notable rate of prosthetic valve involvement.
- Third-generation cephalosporins were the most frequently used antibiotics, with a median treatment duration of six weeks.
- A 10% mortality rate was observed among treated patients, emphasizing the need for early diagnosis and intervention.

## Abstract

Salmonella sp. is a rare cause of infective endocarditis (IE). We present a case of endocarditis diagnosed in an 80-year-old man who had undergone multiple aortic valve replacements and had a recurrence of Salmonella sp. bacteremia with hyperfixation on positron emission tomography (PET) scan and an aortic periprosthetic false aneurysm suggestive of a paravalvular abscess on cardiac scan. Treatment consisted of aortic valve replacement and curative antibiotic therapy with ceftriaxone, and the patient is still alive and asymptomatic on suppressive antibiotics with cotrimoxazole. We also present a review of Salmonella sp. IE in the PubMed and Google Scholar databases between 2014 and 2023. A total of 39 patients were included, including one case managed by our team. The median age was 55 years, and the most commonly involved valves were mitral and aortic in 43% and 41% of cases, respectively. Thirty-one percent of patients had prosthetic valve endocarditis. Salmonella enterica subsp. enterica serovar Enteritidis was the main pathogen in 41% of patients. Surgery was performed in 36% of cases. The most common antibiotic was a third-generation cephalosporin in 67% of cases, and the median duration of treatment was six weeks. Mortality under treatment was 10%. In the case of recurrent Salmonella bacteremia, endocarditis must be considered.