Introduction:

Bacterial endocarditis is a rare disease, caused in most cases by gram-positive organisms, such as staphylococci and streptococci, followed by HACEK group organisms and rarely by non-HACEK gram-negative organisms. Its incidence is low, but it is related to high mortality; there are several associated risk factors: advanced age, female sex, history of heart surgery, prosthetic valves, use of central venous or urinary catheters.

Objective:

To describe the available evidence on bacterial endocarditis due to Escherichia coli.

Case report:

We describe the case of an elderly patient, without a history of cardiac surgery, who showed disorientation, asthenia, adynamia, elevation of body temperature, associated with urinary infection, persisting after taken piperacillin-tazobactam for 7 days with temperature rises. Blood cultures confirm Escherichia coli bacteremia and transesophageal echocardiography exhibited vegetation at the native aortic valve level. The patient received antibiotic treatment with third-generation cephalosporin for 30 days, with clinical improvement, echo transesophageal control with no vegetations, and no immediate need for surgical treatment.

Conclusions:

The clinical suspicion of endocarditis is vital when requesting diagnostic tests and interpreting their results.

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