BACKGROUND: Gram-negative bacteria are rarely the cause of infective endocarditis, especially in patients without cardiovascular risk factors. To our knowledge, only 30 cases due to Enterobacter cloacae have been reported in the literature and 1 was suspected of producing extended-spectrum β-lactamases.

CASE REPORT: We present a patient with extended-spectrum β-lactamase-producing Enterobacter cloacae infective endocarditis. The patient underwent surgery to replace the affected valve, is being treated with meropenem and amikacin, and currently has a favorable course.

CONCLUSIONS: We review past cases and discuss the need for surgical intervention and dual antibiotic therapy according to current guidelines and evidence.

Keywords: Endocarditis, Enterobacter cloacae, Gram-Negative Bacteria