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Native valve Proteus mirabilis endocarditis: successful treatment of a rare entity formulated by in vitro synergy antibiotic testing
  1. Caroline R Brotzki1,
  2. Kari A Mergenhagen2,
  3. Zackery P Bulman3,
  4. Brian T Tsuji3,
  5. Charles S Berenson4,5
  1. 1Department of Medicine, University at Buffalo State University of New York, School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  2. 2Department of Pharmacy, Veterans Administration Western New York Healthcare System, Buffalo, New York, USA
  3. 3Laboratory for Antimicrobial Pharmacodynamics, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York, USA
  4. 4State University of New York at Buffalo, Buffalo, New York, USA
  5. 5Veterans Administration Western New York Healthcare System, Buffalo, NY, USA
  1. Correspondence to Dr Charles S Berenson, berenson{at}


Infective endocarditis caused by Proteus mirabilis is a rare and poorly reported disease, with no well-defined effective antibiotic regimen. Here, we present a case of P. mirabilis aortic valve endocarditis. We reviewed prior cases and treatment regimens, and devised effective treatment, which was guided by in vitro sensitivity and synergy testing on the pathogen. Our patient survived without complications or the need for a surgical intervention.

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  • Contributors CRB is responsible for manuscript composition and lead author. KAM is responsible for directed clinical and pharmacological research. ZPB is responsible for time-kill and synergy studies. BTT is responsible for time-kill and synergy studies. CSB is responsible for directed manuscript composition and patient care. All five authors contributed to conceptions and design, analysis and interpretation of data, drafting and revising of the article. All gave final approval and all are in agreement with accountability and accuracy of the data.

  • Funding National Institute of Allergy and Infectious Diseases (R01AI111990).

  • Competing interests None declared.

  • Patient consent Obtained.

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

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