A case of native valve endocarditis caused by Burkholderia cepacia without predisposing factors

Here, we report the case of a patient who developed Burkholderia cepacia-induced native valve endocarditis with consequent cerebral involvement without any predisposing factors; she was successfully treated by antimicrobial agents only.In this report, we also present literature review of relevant cases.Burkholderia cepacia is a gram-negative bacillus. It is important nosocomial pathogen that particularly infects patients with cystic fibrosis [1] and chronic granulomatous diseases[2] and is known to be resistant to many anti-bacterial agents.Burkholderia cepacia rarely causes endocarditis in community settings, but it is known to cause infective endocarditis particularly in intravenous heroin users, and in patients with prosthetic valve replacement [3]. However, infective endocarditis caused by Burkholderia cepacia in patients without predisposing factors is rare [4-6].The treatment of Burkholderia cepacia endocarditis could be conservative, i.e., administration of antibacterial agents, and/or surgical modality [4-13]. According to the previous reports, most patients were prescribed trimethoprim-sulfamethoxazole and underwent valve surgery. Notwithstanding, the mortality in cases of infective endocarditis patients is not low despite the aggressive treatment of infective endocarditis [3].Here, we report the case of a patient with Burkholderia cepacia endocarditis and cerebral involvement who had no predisposing factors, and the infection was successfully managed only by antimicrobial treatment. Along with this case, we also present a literature review.A 77-year-old woman was transferred to our hospital from a local hospital for loss of consciousness and disorientation. She had experienced a fall 2 weeks before admission to our hospital. Plain spine radiography had revealed a spine compression fracture. Two days earlier, she was admitted to a local hospital for relief from back pain. However, during her stay at the hospital, she developed low grade fever, aphasia, and