A Case Report of CultureNegative Burkholderia Prosthetic Valve Endocarditis Identified by Metagenomic NextGeneration Sequencing (mNGS)

Burkholderia cepacia complex is a group of closely related opportunistic Gram-negative species that can be found in soil and water. Burkholderia cepacia complex is commonly associated with pulmonary infections in patients with cystic fibrosis, hospital-borne outbreaks related to contaminated medicines and devices, and, rarely, prosthetic valve endocarditis. The treatment of Burkholderia cepacia remains challenging because of the organism’s intrinsic resistance to several antibiotics, and often requires combination therapy. Through this clinical vignette, we review an interesting case of culture-negative Burkholderia prosthetic valve endocarditis identified through metagenomic next-generation sequencing (mNGS) and the challenges associated with the diagnosis and selection of an appropriate treatment.