1. Invasive pyogenic infection and infective endocarditis due to Streptococcus anginosus
- Author
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Cheng, Chiao-Wen, Feng, Cheng-Min, and Chua, Chian Sem
- Subjects
Brain Infarction ,Mitral Valve Prolapse ,Adolescent ,Endocarditis ,infective endocarditis ,Brain Abscess ,Mitral Valve Insufficiency ,Recovery of Function ,Anti-Bacterial Agents ,renal embolization ,Treatment Outcome ,brain microabscess ,Streptococcus anginosus ,Echocardiography ,Streptococcal Infections ,Humans ,Administration, Intravenous ,Female ,Clinical Case Report ,Research Article - Abstract
Rationale: Streptococcus anginosus mostly colonizes the digestive and genitourinary system, including the oropharyngeal region. It commonly causes invasive pyogenic infection, but less likely causes infective endocarditis (IE). Patient concerns: An 18-year-old woman who had an underlying mitral valve prolapse without mitral regurgitation presented to our hospital with low-grade fever, left leg weakness, and left abdominal pain. She was diagnosed with brain infarction and microabscess as well as IE. The patient totally recovered after the 6-week course of intravenous antibiotics. Diagnosis: Brain magnetic resonance imaging revealed brain infarction and microabscess. Abdominal computed tomography revealed splenic and left renal infarction. Three sets of blood culture were positive for S anginosus. Transthoracic echocardiogram identified mitral valve prolapse with moderate eccentric mitral valve regurgitation, and a 0.3 × 0.6-cm vegetation was found on the left mitral valve. All of these results meet the modified Duke criteria. Interventions: The abdominal pain and left leg weakness were improving after 2 weeks of intravenous antibiotics treatment. No neurological sequelae were noted after completing the 6-week course of medical treatment. Outcomes: The patient was successfully treated and discharged after completing the 6-week intravenous antibiotics treatment. Lessons: IE should be considered in young patients with native valve disease who have prolonged fever. Though S anginosus commonly causes invasive pyogenic infection, patients with native valve disease should be checked for IE.
- Published
- 2019