Complete heart block associated with tricuspid valve endocarditis due to extended spectrum β-lactamase-producing Escherichia coli.

We report a case of complete heart block associated with tricuspid endocarditis due to extended-spectrum β-lactamase-producing Escherichia coli (ESBL E. coli) following a transrectal prostate biopsy. This is the first report of complete heart block associated with tricuspid native valve endocarditis. In addition, this is also the first reported case of ESBL E. coli causing endocarditis of any kind. Prompt antibiotic therapy resulted in a downgrading of the high-grade conduction block and eventual cure of an associated complication, vertebral osteomyelitis, and discitis. The anatomy and microbiology of endocarditis in the context of heart block are presented and discussed.