A rare case report of infective endocarditis caused by Enterococcus gallinarum following renal laser lithotripsy

Rationale: Enterococcus gallinarum is a part of the normal fecal microbiota in the general population and animals, and is rarely isolated in clinical specimens. Due to the increasing use of immunosuppressants, invasive treatments, and overuse of antibiotics, infections caused by enterococci are gradually increasing. Patient concerns: A 48-year-old man was admitted to our hospital due to a persistent fever for 1 month after renal laser lithotripsy. Diagnoses: The cardiac ultrasound showed a mass on the mitral valve leaflet of the left atrium. The metagenomic next-generation sequencing test results of blood and vegetation were positive, reporting a large number of characteristic reads of E. gallinarum. The patient was diagnosed with infective endocarditis. Interventions: Mechanical mitral valve replacement was performed, and daptomycin was administered during the perioperative period. Outcomes: After 4 weeks of antibiotic treatment, the patient's inflammatory indexes were normal, and no abnormalities such as fever were found. Blood culture and metagenomic next-generation sequencing test results were negative. The patient was then discharged from the hospital. Lessons: This case emphasizes the possibility of E. gallinarum developing severe invasive infections after kidney surgery. Clinical doctors should strengthen their understanding of this type of bacteria, understand their sensitive characteristics and treatment principles.