Streptococcus agalactiae (Group B Streptococcus) Infective Endocarditis Complicated by Myocardial Abscess and Heart Block

Chang, Monique; Cunha, Burke A.

doi:10.1097/01.idc.0000121026.62151.5b

Cited by 6 publications

(10 citation statements)

References 21 publications

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“…Whilst he had no pre-existing cardiac pathology, the history of frequent UTIs secondary to a urethral stricture probably accounts for the offending organism. To date, to the best of our knowledge, only two other cases of GBS endocarditis complicated by myocardial abscess formation and perivalvular abscess have been reported in the literature (Scully et al, 1987;Chang & Cunha, 2004). …”

Section: Discussionmentioning

confidence: 99%

“…Although usually associated with post-partum endocarditis prior to the antibiotic era, cases of GBS have increased in adults, mainly in elderly patients or in those with risk factors that include chronic immunosuppressive diseases such as diabetes mellitus, alcoholism, intravenous drug use, neoplasia and human immunodeficiency virus infection (Sambola et al, 2002;Chang & Cunha, 2004). Common identifiable sources for GBS include soft-tissue infection, gynaecological infection and UTIs.…”

Section: Discussionmentioning

confidence: 99%

“…Endocarditis is rare and typically is seen in immunocompromised individuals. These are aggressive infections with high levels of systemic complications and mortality rates, which may be explained by the pathogen's lack of fibrinolysin (Sambola et al, 2002;Chang & Cunha, 2004). Myocardial abscess is a rare complication, with only two current reports (Scully et al, 1987;Chang & Cunha, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…These are aggressive infections with high levels of systemic complications and mortality rates, which may be explained by the pathogen's lack of fibrinolysin (Sambola et al, 2002;Chang & Cunha, 2004). Myocardial abscess is a rare complication, with only two current reports (Scully et al, 1987;Chang & Cunha, 2004). Whilst medical management may appear beneficial in the absence of indications for emergent surgery, urgent and radical surgical debridement may improve prognosis (Scully et al, 1987;Sambola et al, 2002;Prendergast & Tornos, 2010;Kang et al, 2012) We report a case of GBS infectious endocarditis complicated by left ventricular-aortic valve discontinuity and myocardial abscess in a young, previously healthy male.…”

Section: Introductionmentioning

confidence: 99%

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Endocarditis and myocardial abscess caused by group B Streptococcus

et al. 2015

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Introduction: Group B Streptococcus (GBS) is a rare infectious endocarditis. Patients with GBS infective endocarditis have a high rate of local and systemic complications.Case presentation: A 30-year-old male presented to the Emergency Department with fever, chills, fatigue and a recent onset of symptoms suggestive of stroke following a bout of pyelonephritis. Echocardiography confirmed a diagnosis of endocarditis and blood cultures grew GBS. Antibiotic therapy was initiated with penicillin G and gentamicin. Urological evaluation revealed a urethral stricture. He was taken to the operating room on hospital day 10 for the debridement of his aortic annulus, reconstruction of his aortic root and replacement of his aortic valve. On post-operative day 7, he died of sudden cardiac arrest. A large myocardial abscess located within the interventricular septum was identified post-mortem.Conclusion: Recurrent or complicated urinary tract infections are rare among the young male population. Without evaluation and treatment for the underlying pathology, patients are at risk of developing antimicrobial-resistant infections, which may disseminate rapidly. Although a common pathogen of the urinary tract, GBS is a rare infectious agent for endocarditis. We propose urethral stricture as a risk factor for developing GBS endocarditis. Operative timing for these infections can be challenging; however, urgent and radical surgical debridement appears to yield favourable results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endocarditis and myocardial abscess caused by group B Streptococcus

et al. 2015

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“…Only 2-9% cases of Streptococcus agalactiae bacteremia present as endocarditis. The typical patient with SA endocarditis in the pre-antibiotic era was a young pregnant woman with the mitral disease; moreover, adults with significant underlying diseases with impaired immune competence, such as diabetes mellitus, alcoholism, chronic hepatic dysfunction, malignant neoplasms, AIDS, and intravenous drug use, are also prone to be infected by this microorganism [1].…”

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confidence: 99%

An “aubergine” in the heart: huge native mitral valve endocarditis caused by Streptococcus agalactiae

2017

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A 52-year-old woman presented to the emergency department (ED) of the ARNAS Civico, Di Cristina, Benfratelli, Palermo (Italy) in January, suffering from fluctuating fever for 3 days, up to 39°C, associated with dyspnea/orthopnea and headache followed by vertigo and left hemiplegia. A cranial computed tomography without contrast, performed in the ED, showed focal hypodensity in the putamen of the right hemisphere; ECG showed sinus tachycardia and a posterior-anterior chest X-ray study showed mild signs of pulmonary vasculature congestion. For this reason, the patient was admitted to the internal medicine department with a diagnosis of ischemic stroke and fever.Physical examination on admission revealed fever (temperature 38.6°C), tachypnea at rest (32 breaths/min), oxygen saturation of pulse oximetry measurement 83%, blood pressure 120/65 mmHg, pulse rate 110 beats/min, no lower extremity edema or jugular venous distention. Chest auscultation revealed bilateral pulmonary crackles. Cardiac auscultation documented a grade 4/6 pansystolic murmur at the mitral valve area radiated to the left anterior axillary line; for this reason, on the second day of admission, bedside transthoracic echocardiogram (TTE) was performed.The TEE revealed a giant (4.06 cm maximum diameter), pedunculated, and highly mobile vegetation attached to the atrial surface of the posterior mitral leaflet, prolapsing into the left ventricle during the ventricular diastolic phase and into the left atrium during ventricular systole phase (Fig.

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Group B streptococcal infective endocarditis

Abdelghany

Schenfeld

2014

Journal of Infection and Public Health

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Streptococcus agalactiae (S. agalactiae), also referred as group B streptococcus (GBS), is an important pathogen in neonates and a rare cause of invasive infection in adults. It is well known that GBS endocarditis is a virulent infection that can cause serious complications. The overall mortality rate remains high despite surgical treatment. We describe a case of native mitral valve endocarditis caused by GBS in an 86-year-old woman treated medically.

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Streptococcus agalactiae (Group B Streptococcus) Infective Endocarditis Complicated by Myocardial Abscess and Heart Block

Cited by 6 publications

References 21 publications

Endocarditis and myocardial abscess caused by group B Streptococcus

Endocarditis and myocardial abscess caused by group B Streptococcus

An “aubergine” in the heart: huge native mitral valve endocarditis caused by Streptococcus agalactiae

Group B streptococcal infective endocarditis

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