Polymicrobial Endocarditis with Eight Pathogens in an Intravenous Drug Abuser

Abstract

A 17-year-old intravenous drug abuser with tricuspid endocarditis required valvulectomy for refractory infection due to 8 different bacterial pathogens. Only one organism was isolated from blood cultures in the first 48 h, and subsequent organisms were not isolated until 9–13 days after hospitalization. The spectrum of pathogens in this patient strengthens previous clinico-bacteriologic observations made in the literature, and emphasizes the need for empiric coverage of oropharyngeal flora in addition to the usual skin flora involved in drug-addict associated endocarditis.