Enterobacter Cloacae Device Endocarditis: Case Report, Scoping Study, and Guidelines Review.

While traditionally an infection of the endocardial surface of heart valves, infective endocarditis (IE), can atypically present as infection of cardiac implantable electronic devices (CIED), including permanent pacemakers (PPM) or automatic implantable cardioverter-defibrillators (AICD). CIED endocarditis, similar to valvular IE, is generally caused by Gram-positive organisms such as Staphylococcus spp., most frequently S. Auerus, but is rarely caused by gram-negative bacteria, both HACEK and non-HACEK species. We present the case of Enterobacter cloacae CIED endocarditis. We also present a scoping study of previous case reports and case series highlighting the risk factors, surgical interventions, and mortality outcomes associated with E. Cloacae endocarditis. We also discuss the current guidelines and recommendations on antibiotic therapies for non-HACEK Gram-negative endocarditis and surgical management of infected CIED extraction and replacement.