Lactococcus garvieae prosthetic aortic and mitral valve endocarditis with multiple embolic complications: a case report

Lactococcus garvieae is a facultatively anaerobic gram-positive coccus which causes lactococcosis, a septicaemic illness in fish of major aquacultural significance. This pathogen has emerged in recent years as a cause of zoonotic infections including infective endocarditis, primary bacteraemia, peritonitis and orthopaedic infections, with putative risk factors such as raw seafood ingestion and underlying gastrointestinal disease. We report a case of L. garvieae bioprosthetic aortic and mitral valve endocarditis in a 75-year-old man, complicated by multiple cerebral septic emboli, lumbar discitis/osteomyelitis and bilateral pulmonary nodules. Despite initial stabilisation with antibiotic therapy and medical heart failure management, the patient deteriorated approximately a year after his index admission with worsening valvulopathy and ultimately died of complications of his infection. This case highlights the emergence of L. garvieae as an opportunistic pathogen in humans, with increasing cases identified due to improved recognition and enhanced diagnostics.