International Journal For Multidisciplinary Research

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A Case of prosthetic valve endocarditis (PVE) caused by methicillin resistant coagulase negative staphylococci (MR-CoNS) with atypical presentation

Author(s) Dr. kee chun tee, Cheng Huong Ngan
Country Malaysia
Abstract Infective endocarditis (IE) is associated with high morbidity and mortality rate of 8-40%1. IE can manifest with various presentations which may or may not be typical and classical symptoms. Early detection and high suspicion are key to early intervention and may significantly improves patient’s prognosis. We presented a case of 37-year-old male who presented with swelling and pain over sternotomy scar for 2 days. On presentation, she was conscious but with signs of septic shock requiring inotropic support and broad-spectrum intravenous antibiotics. Initial echocardiography (ECHO) showed no vegetation. Ultrasound anterior chest wall showed sternal hypoechoic collection with suspicious of intrathoracic extension. Contrast enhanced computed tomography (CECT) thorax confirmed subcutaneous hypodense collection at the mid sternal region but no CT evidence of intrathoracic extensions. Subsequently incision and drainage (I&D) were done and noted hemopurulent pus. First blood culture taken upon admission reported as methicillin resistant coagulase negative staphylococci (MR-CoNS), however it was not treated initially due to doubtful significance and possible contamination from skin flora in addition to having an obvious source of sepsis over anterior chest wall. Pus culture taken during I&D showed no growth but patient remained febrile and subsequent 2 sets of repeated blood culture showed MR-CoNS. A repeated ECHO was done and noted a vegetation of 0.5cm over aortic valve. Patient was treated for PVE caused by MR-CoNS with IV vancomycin, Rifampicin and Gentamicin. She had good recovery with no signs of heart failure or significant impairment of quality of life.
Keywords infective endocarditis, prosthetic valve endocarditis, methicillin resistant coagulase negative staphylococci
Field Medical / Pharmacy
Published In Volume 8, Issue 1, January-February 2026
Published On 2026-02-04
DOI https://doi.org/10.36948/ijfmr.2026.v08i01.68079
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