# Leclercia adecarboxylata: A Rare and Emerging Cause of Gram-Negative Infective Endocarditis

## TL;DR

A rare bacterial infection caused by Leclercia adecarboxylata in a patient with liver disease highlights challenges in treating immunocompromised individuals.

## Contribution

This case report highlights Leclercia adecarboxylata as an emerging cause of infective endocarditis in immunocompromised patients.

## Key findings

- Leclercia adecarboxylata was identified in blood cultures of a patient with liver cirrhosis and infective endocarditis.
- The patient's condition worsened despite prolonged antibiotic treatment and supportive care.
- The case underscores the difficulty of managing IE in immunocompromised individuals with underlying liver disease.

## Abstract

Infective endocarditis (IE) is a serious and life-threatening condition often associated with high morbidity and mortality, particularly in immunocompromised populations. We present a case of IE caused by the gram-negative pathogen Leclercia
adecarboxylata in a 37-year-old male with advanced alcohol-related liver cirrhosis complicated by portal hypertension, ascites, and episodes of hepatic encephalopathy. The patient presented initially with decompensation of his liver disease and later developed a fever. L.
adecarboxylata was identified in blood cultures together with an aortic valve lesion. Despite aggressive management with a prolonged course of intravenous antibiotics and supportive care, the patient's clinical course was marked by repeated bacteremia and progressive decompensation of liver disease. This case illustrates the increasing clinical significance of L.
adecarboxylata in immunocompromised hosts and highlights the unique challenges of managing IE in a patient with cirrhosis.