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Meningitis and endocarditis caused by group B streptococcus in a human immunodeficiency virus (HIV) infected patient

R Civljak1, M Lisić, J Begovac

  • 1Dr Fran Mihaljević University Hospital for Infectious Diseases, Mirogojska 8, 10000 Zagreb, Croatia. rcivljak@fran.bfm.hr

Croatian Medical Journal
|October 12, 2001
PubMed

Insights

This case report details Streptococcus agalactiae meningitis and endocarditis in an adult with HIV. This rare dual infection highlights the importance of considering invasive group B streptococcus in immunocompromised individuals.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Neurology

Background:

  • Adult meningitis and endocarditis caused by Streptococcus agalactiae (group B Streptococcus) are rare.
  • Human immunodeficiency virus (HIV) infection is a known risk factor for invasive bacterial infections.

Observation:

  • A 45-year-old homosexual male with HIV presented with fever, confusion, and meningeal irritation.
  • Cultures revealed Streptococcus agalactiae in blood, urine, and cerebrospinal fluid (CSF).
  • Echocardiography identified vegetations on the mitral and aortic valves, indicating endocarditis.

Findings:

  • The patient was diagnosed with concomitant meningitis and endocarditis due to Streptococcus agalactiae.
  • This represents a rare instance of this dual infection, with only a few prior cases of meningitis reported, none with endocarditis.
  • Successful treatment with antibiotics led to clinical improvement and resolution of CSF and echocardiographic abnormalities.

Implications:

  • This case underscores the potential for severe, invasive group B streptococcal infections in adult patients with HIV.
  • Clinicians should maintain a high index of suspicion for Streptococcus agalactiae in immunocompromised patients presenting with meningitis or endocarditis symptoms.
  • Prompt diagnosis and comprehensive antibiotic therapy are crucial for managing these life-threatening co-infections.

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