Leclercia adecarboxylata: A Rare and Emerging Cause of Gram-Negative Infective Endocarditis.

Infective endocarditis (IE) is a serious and life-threatening condition often associated with high morbidity and mortality, particularly in immunocompromised populations. We present a case of IE caused by the gram-negative pathogen Leclercia adecarboxylata in a 37-year-old male with advanced alcohol-related liver cirrhosis complicated by portal hypertension, ascites, and episodes of hepatic encephalopathy. The patient presented initially with decompensation of his liver disease and later developed a fever. L. adecarboxylata was identified in blood cultures together with an aortic valve lesion. Despite aggressive management with a prolonged course of intravenous antibiotics and supportive care, the patient's clinical course was marked by repeated bacteremia and progressive decompensation of liver disease. This case illustrates the increasing clinical significance of L. adecarboxylata in immunocompromised hosts and highlights the unique challenges of managing IE in a patient with cirrhosis.