Infective endocarditis caused by non-HACEK Gram-negative bacilli

Background

• Rare, accounting for 1-2% of cases
• Often associated with either healthcare exposure or injection drug use
• Most commonly caused by Pseudomonas aeruginosa and Escherichia coli
  • Extremely rarely caused by Salmonella

Clinical Manifestations

Prognosis

• High mortality, up to 25%

Management

• Surgery
• Antibiotic therapy
  • Multidrug regimens are sometimes used, often a beta-lactam plus aminoglycoside or fluoroquinolone
  • Duration is typically 6 weeks