Rare coincidence: endocarditis and pyomyositis by Escherichia coli in immunosuppressed patient




Donaldo E. Silva-López, Departamento de Cardiología, Medicina Interna, Hospital Civil de Guadalajara, Universidad Autónoma de Guadalajara, Secretaría de Salud, Guadalajara, Jal., México
Marco A. Ponce-Gallegos, Departamento de Cardiología, Instituto de Cardiología Ignacio Chávez, Secretaría de Salud, Ciudad de México, México
César Márquez-Acéves, Departamento de Infectología, Medicina Interna, Hospital Civil de Guadalajara, Universidad Autónoma de Guadalajara, Secretaría de Salud, Guadalajara, Jal., México
Anett C. Ortíz-Pérez, Departamento de Medicina Interna, Hospital Civil de Guadalajara, Universidad Autónoma de Guadalajara, Secretaría de Salud, Guadalajara, Jal. México
Iván A. Vargas-Moreno, Departamento de Cardiología, Centenario Hospital Miguel Hidalgo, Universidad Autonoma de Aguascalientes, Secretaría de Salud, Aguascalientes, Ags., México
Mario A. Álvarez-Rodríguez, Departamento de Cardiología, Centenario Hospital Miguel Hidalgo, Universidad Autonoma de Aguascalientes, Secretaría de Salud, Aguascalientes, Ags., México
Norma J. Ibarra-Sepúlveda, Servicio de Medicina Interna, Hospital General Regional 180, IMSS, Tlajomulco, Jal., México


Infective endocarditis caused by Escherichia coli is rare but its incidence is increasing, with a high mortality compared to the HACEK group. While E. coli is common in bacteremia, it rarely causes endocarditis. Diagnosis is based on positive blood cultures and echocardiography showing vegetations. Pyomyositis, another bacterial infection predominantly affecting immunocompromised individuals, can be caused by E. coli. We describe the case of a woman with sepsis and the rare association of endocarditis and pyomyositis due to E. coli, resulting in a fatal outcome. Treatment includes third-generation antibiotics and intensive monitoring. Surgical intervention may be necessary in severe complications.



Keywords: Endocarditis. Escherichia coli. Pyomyositis. Bacteremia. Antibiotics.