Aortic root abscess

Background

• A rare complication of infective endocarditis
• Perivalvular complications, including artic root abscess, occur in about 10% of cases (more in prosthetic valve endocarditis)

Microbiology

• Predominantly gram-positive organisms, and specifically Staphylococcus aureus1
• Staphylococcus (40%)
  • Staphylococcus aureus (25%)
  • Staphylococcus epidermidis (7%)
  • Other staphylococci (7%)
• Streptococcus (23%)
  • Streptococcus bovis (3%)
  • Other streptococci (20%)
• Enterococcus (15%)
  • Enterococcus faecalis (12%)
  • Other enterococci (3%)
• Gram-negative bacilli (3%)
  • Escherichia coli (2%)
  • Proteus (11%)
• Candida (2%)
• Culture-negative endocarditis (17%)

Management

• Usually requires surgery