Background Infective endocarditis (IE) remains associated with substantial morbidity and mortality despite advances in diagnosis and treatment. Transoesophageal echocardiography (TOE) is central to the diagnosis of IE; however, contemporary data examining the relationships among dental exposure, microbiological findings, and echocardiographic characteristics in routine clinical practice remain limited, particularly in district general hospitals (DGHs). Methods We conducted a retrospective observational study of consecutive TOE examinations performed for suspected IE at Royal Derby Hospital, a United Kingdom (UK) teaching DGH, between April 2022 and October 2024. A total of 145 consecutive TOE examinations performed for suspected IE were screened. Twelve examinations were excluded because IE was not confirmed or because they were duplicate or repeat examinations relating to the same infective episode, leaving 133 unique confirmed clinical episodes of IE for the final analysis. Demographic, microbiological, echocardiographic, treatment, and outcome data were collected retrospectively. The primary analysis evaluated the association between documented dental procedures and oral flora-associated IE, while secondary analyses described echocardiographic findings, microbiological profiles, surgical intervention, and in-hospital mortality. Results Among the 133 unique confirmed clinical episodes of IEepisodes, the mean patient age was 63.3 years, and 66.2% of patients were male. Native-valve IE accounted for 75.9% of cases. The aortic valve was the most frequently affected structure (62.4%), while Staphylococcus aureus was the predominant causative organism (30.8%). Oral flora organisms accounted for 33.1% of infections. Twenty-six patients (19.5%) underwent surgical or device intervention, and the in-hospital mortality rate was 11.3%. Among the 26 patients with documented dental procedures, antibiotic prophylaxis was documented for two (7.7%). Documented dental procedures were associated with a higher frequency of oral flora-associated IE (50.0% vs. 28.8%; odds ratio, 2.47; 95% confidence interval, 1.03-5.94; p = 0.040). No clinical, microbiological, or echocardiographic variable demonstrated a significant association with in-hospital mortality. Conclusions In this contemporary cohort of patients with confirmed IE who underwent TOE, documented dental exposure was significantly associated with oral flora-associated IE. The study also demonstrates that aortic valve involvement, Staphylococcus aureus infection, and native-valve disease remain common in routine UK practice. The low rate of documented antibiotic prophylaxis may highlight an opportunity to improve documentation, although prospective studies are needed to determine the true rate of prophylaxis administration.

Corynebacterium species are often regarded as skin contaminants when isolated from clinical cultures. However, in select high-risk patients, these organisms can lead to significant infections, including infective endocarditis. We present the case of a 76-year-old woman with multiple comorbidities, including end stage renal disease (ESRD) on hemodialysis and an exposed tunneled central catheter, who developed Corynebacterium-associated native mitral valve endocarditis requiring surgical intervention. Despite prompt antimicrobial therapy and bioprosthetic valve replacement, her hospital course was complicated by heart block, empyema, and eventual cardiac arrest. This case highlights the importance of recognizing Corynebacterium as a potential pathogen in vulnerable patients and reviewing the growing body of literature on this rare but serious cause of endocarditis.

Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) with unique virulence traits that mimic Staphylococcus aureus, despite traditionally being grouped among less pathogenic skin flora. Unlike other CoNS, S. lugdunensis can infect native valves and cause aggressive infective endocarditis (IE). We present a rare and instructive case of S. lugdunensis native mitral valve endocarditis complicated by cerebral embolic infarctions and requiring surgical valve replacement in a patient on chronic peritoneal dialysis. This case underscores the diagnostic challenge of CoNS bacteremia, highlights the embolic potential of S. lugdunensis, and represents one of the few documented cases of stroke complicating S. lugdunensis IE in a dialysis-dependent patient without prosthetic devices.

[This corrects the article DOI: 10.3389/fmed.2026.1872023.].

Infective endocarditis (IE) is a severe cardiovascular disease characterized by the formation of vegetations on heart valves. This study investigates the role of von Willebrand Factor (VWF) in the pathogenesis of Streptococcus mutans-induced endocarditis using two distinct mouse models: damage-induced and inflammation-induced endocarditis. We employed histological analysis, immunofluorescence, scanning electron microscopy, and molecular techniques to elucidate the mechanisms of vegetation formation and the contribution of VWF in each model. Our results demonstrate that VWF is critical for vegetation formation in S. mutans-induced IE, with more pronounced effects in damage-induced models. VWF deficiency reduces valve colonization, and vegetation size, while supplementation restores these phenotypes. Mechanistically, VWF might upregulates IL-17A/ICAM-1 signaling to amplify inflammation and collagen deposition, which was validated by genetic knockout and antibody blockade. Furthermore, our study provides novel insights into the interplay between VWF and inflammatory responses during endocarditis progression, opening new avenues for understanding the complex pathophysiology of this life-threatening condition.