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First Danish case of infective endocarditis caused by Enterococcus hirae
  1. Mette Winther1,
  2. Michael Dalager-Pedersen2,3,
  3. Irene Harder Tarpgaard1 and
  4. Hans Linde Nielsen1,3
  1. 1Department of Clinical Microbiology, Aalborg University hospital, Aalborg, Denmark
  2. 2Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
  3. 3Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  1. Correspondence to Dr Hans Linde Nielsen; halin{at}


Enterococcus hirae, a member of the Enterococcus genus, is known to cause infections, including infective endocarditis (IE), in animal species. In humans, E. hirae is an uncommon pathogen, but has been associated with severe and recurrent disease. Here, we report the first Danish case of E. hirae native aortic valve IE in a 62-year-old woman with no history of heart disease. She presented to the hospital with symptoms of gastroenteritis but no signs of heart disease. Nevertheless, blood culture revealed growth of E. hirae, and a transoesophageal echocardiography demonstrated a mobile mass adherent to the aortic valve, compatible with a vegetation. The patient was successfully treated for E. hirae native aortic valve IE with 4 weeks of intravenous benzylpenicillin in combination with gentamicin for the initial 2 weeks. To the best of our knowledge, this is the first documented case of E. hirae IE in Denmark and the sixth documented case worldwide.

  • valvar diseases
  • infections

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  • Contributors All authors contributed to the manuscript. MW and HLN wrote the first draft. HLN performed the bacterial identification and susceptibility testing. IHT performed the WGS sequencing. MD-P accounted for the clinical management of the patient and made final revisions to the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.