<xhtml:span xmlns:xhtml="http://www.w3.org/1999/xhtml" xml:lang="en">Enterococcus faecalis Infective Endocarditis of a TAVR Valve Temporally Associated with Colonoscopic Polypectomy: A Case Report and Review of the Literature  </xhtml:span>
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Infective endocarditis (IE) involving transcatheter aortic valve prostheses is an uncommon but life-threatening complication, with Enterococcus faecalis among its leading causative organisms. Here, we report a 79-year-old woman with a transcatheter aortic valve prosthesis and a solitary functioning kidney who developed E. faecalis endocarditis five weeks after a colonoscopy with cold-snare polypectomy. She initially presented with fever and altered mental status but was discharged after a reassuring evaluation; blood cultures subsequently grew E. faecalis, and she was advised to return for further evaluation. Transesophageal echocardiography (TEE) demonstrated a small vegetation on the bioprosthetic aortic valve, and imaging revealed splenic and cerebral emboli. Most published cases of E. faecalis IE temporally associated with colonoscopy have presented within two weeks of the procedure, although delayed presentations similar to ours have been reported. Concurrent periapical dental disease precluded definitive identification of the portal of entry. Together with previous reports, this case suggests that the interval between colonoscopy and E. faecalis infective endocarditis may extend beyond the commonly reported early window.
