Infective endocarditis in neutropenic patients with viridans streptococci bacteraemia

Abstract

Viridans streptococci (VS) are important agents of bacteraemia in neutropenic patients and important agents of community-acquired infective endocarditis (IE) in non-neutropenic patients. However, the incidence of IE in neutropenic patients seems to be rare. In this systematic review of the literature we sought to answer the following questions: (1) What is the frequency of IE in neutropenic patients with VS bacteraemia? (2) What is the most frequent clinical presentation of IE? (3) Is routine investigation for IE indicated in neutropenic patients with VS bacteraemia? The incidence of IE in patients with VS bacteraemia was 0.74% and a new cardiac murmur was the most frequent clinical presentation. Given the rarity of IE in neutropenic patients, routine investigation with echocardiography is not indicated. However, the presence of a new significant murmur should prompt appropriate investigation to rule out IE.