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Background  Native valves infective endocarditis due to  Escherichia coli  is still a rare disease and a particular virulence of some  E.coli  isolate may be suspected.    Case presentation  A 79-year-old woman presented during the post-operative period of an orthopedic surgery a urinary tract infection following obstructive ureteral lithiasis.  E. coli  was isolated from a pure culture of urine and blood sampled simultaneously. After evidence of sustained  E.coli  septicemia, further investigations revealed acute cholecystitis with the same micro-organism in biliary drainage and a native valve mitral endocarditis.  E.coli  was identified as O2:K7:H6, phylogenetic group B2, ST141, and presented several putative and proven virulence genes. The present isolate can be classified as both extra-intestinal pathogenic  E.coli  (ExPEC JJ ) and uropathogenic  E. coli  (UPEC HM ).    Conclusions  The relationship between the virulent factors present in ExPEC strains and some serotypes of  E. coli  that could facilitate the adherence to cardiac valves warrants further investigation.

The causal relationship between O2:K7:H6 extra-intestinal pathogenic Escherichia coli (ExPEC) and native valve endocarditis: a case report