Abstract
Endocarditis is a rare presentation of group B streptococcal infection. Its association with pulmonary septic embolism was only barely studied and limited data is available up to date. Multiple septic emboli is a common complication of bacterial endocarditis, but only a few cases have been documented in relation to group B streptococcus. We present the case of an 87 year old female patient with multiple underlying conditions that predisposed the development of bacterial endocarditis secondary to group B streptococcus and subsequently multiple pulmonary septic emboli. The patient was treated with ceftriaxone and azythromycin with good response and complete recovery without any further complications. In the event of a diagnosed case of group B streptococcus endocarditis, there should be a low threshold for the suspicion of septic pulmonary emboli especially in cases with right valves involvement.
Highlights
Streptococcus agalactiae, known as group B Streptococcus (GBS) is a gram positive, facultative anaerobic bacteria associated with infections in three different populations: i) Newborns : GBS is the main cause of sepsis and meningitis; ii) Pregnant woman: It is an important etiologic agent of chorioammnionitis, endometritis, septic abortion and bacteremia[1] and iii) Healthy individuals: GBS rarely causes infection in this group and when it occurs is almost always associated to underlying disease like diabetes mellitus, cardiovascular disease, malignancy and immunodepression.[2,3,4]
Endocarditis is a rare, severe presentation of GBS infection. It accounts for only a minority of all cases of bacterial endocarditis (1.7%) and is mainly found in patients with history of alcoholism, cirrhosis, diabetes and cancer.[2,3,4]
The virulence of the bacteria is reflected in the high rates of mortality that vary from 20-45% as documented by studies and valve compromise.[5]
Summary
Streptococcus agalactiae, known as group B Streptococcus (GBS) is a gram positive, facultative anaerobic bacteria associated with infections in three different populations: i) Newborns : GBS is the main cause of sepsis and meningitis; ii) Pregnant woman: It is an important etiologic agent of chorioammnionitis, endometritis, septic abortion and bacteremia[1] and iii) Healthy individuals: GBS rarely causes infection in this group and when it occurs is almost always associated to underlying disease like diabetes mellitus, cardiovascular disease, malignancy and immunodepression.[2,3,4]. An 87 year old female with history of hypertension and heart failure was admitted to the hospital because of two weeks history of fever, chills, loss of appetite and abdominal discomfort She denied cough, dyspnea, chest pain, palpitations or diaphoresis. The patient complied with taking of the mediation but had no improvement in her condition She had a history of atrial fibrillation and hypothyroidism and received prophylactic warfarin and levothyroxine for treatment of the respective conditions. A computerized tomograph of the chest showed the presence of multiple sizes, scattered lesions in the right lung; some with spiculations and cavitation. These lesions were mostly in the peripheral regions of the lungs, with the largest in the apex of the right lung (Figure 2, 3). Oral antibiotics were prescribed to complete 4 weeks of treatment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
