Septic Embolic Stroke Resulting From Staphylococcus lugdunensis Endocarditis

Background: Staphylococcus lugdunensis, a member of the coagulase-negative staphylococci (CoNS), has been recognized as a causal organism for infective endocarditis since the 1980s. Although most CoNS have an insidious and chronic nature, they are involved in a variety of systemic infections. S lugdunensis infective endocarditis is a rare entity but is as catastrophic as Staphylococcus aureus infective endocarditis and requires aggressive antibiotic therapy and, typically, valve replacement. S lugdunensis infective endocarditis-induced septic embolic cerebrovascular accident has rarely been reported in the literature.

Case report: We present the case of a 63-year-old African American man who presented with sudden-onset aphasia and right-sided hemiplegia and was admitted for the management of cerebrovascular accident. Afterwards, he developed a fever and was found to have S lugdunensis bacteremia, with subsequent imaging revealing vegetations of the mitral valve. Despite being treated with culture-appropriate antibiotics, he remained persistently bacteremic and required surgical mitral valve replacement.

Conclusion: S lugdunensis infective endocarditis is rare but can have a malignant course and requires early surgical intervention in most cases.