A case of group G streptococcal endocarditis masquerading as acute rheumatic fever

Abstract

Cases of infective endocarditis attributable to group G streptococci are uncommon, but may be more virulent and aggressive than viridans group streptococci. This case report documents an unusual presentation of group G streptococcal endocarditis in a previously healthy young man whose initial symptoms and signs of fever, migratory polyarthritis, subcutaneous nodule, new systolic murmur, polyarthralgias, and elevated C-reactive protein (CRP) in the presence of a markedly elevated anti-streptolysin O titre fulfilled three major clinical and three minor criteria of the Revised Jones criteria, leading to an initial working diagnosis of acute rheumatic fever before echocardiography. Clinicians need to be reminded of the masquerading features of infective endocarditis.