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Proteus mirabilis bioprosthetic tricuspid valve endocarditis with massive right ventricular vegetation: a new entity in the prosthetic valve endocarditis aetiology.

Proteus mirabilis (PM) prosthetic valve endocarditis is a rare and life-threatening condition not yet reported on tricuspid bioprostheses. A 43-year old woman, a heroin-user, presented with fever and respiratory failure related to an incipient pneumonia. Blood cultures were positive for PM. Similarly, urine culture and bronchoalveolar lavage were positive for PM. An echocardiography revealed a giant vegetation (Fig. 1A and B; Videos 1 and 2), extended to the pulmonary artery. Tricuspid bioprosthesis re-replacement (Fig. 2) was successfully undertaken, eventually achieving negative cultures.