Clostridium perfringens Infective Endocarditis: Revisiting a Forgotten Pathogen.

BACKGROUND

Clostridium perfringens is a rare cause of infective endocarditis (IE), with only a limited number of cases reported in the literature.

CASE SUMMARY: A 57-year-old man with complex congenital heart disease, including a surgically repaired double-outlet right ventricle and prior pulmonic valve replacement, presented with recurrent fevers and Cperfringens bacteremia. Although transthoracic echocardiography revealed no acute disease, cardiac computed tomography identified a vegetation adherent to the ventricular septal defect patch, an atypical and previously unreported site for this organism. The patient underwent successful treatment with prolonged intravenous penicillin without surgical intervention.

DISCUSSION: Standard echocardiography is limited in the detection of vegetations in repaired congenital heart disease, underscoring the importance of advanced multimodality imaging.

TAKE-HOME MESSAGES: Based on computed tomography-supported findings of IE, the patient underwent successful treatment with prolonged intravenous penicillin without surgical intervention. This case adds to the limited literature on Cperfringens as a rare cause of IE and highlights the importance of individualized, multidisciplinary management in complex congenital heart disease.