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Prosthetic valve endocarditis due to Streptococcus pneumoniae

Ayman Natsheh1, Michal Vidberg2, Reuven Friedmann3

  • 1Department of Medicine B, Shaare Zedek Medical Center, Jerusalem, Israel.

Springerplus
|August 16, 2014
PubMed
Abstract

Insights

Infective endocarditis caused by Streptococcus pneumoniae is rare today, even in older adults and those with prosthetic valves. Prompt antibiotic treatment leads to favorable outcomes, with no increased virulence observed.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Internal Medicine

Background:

  • Streptococcus pneumoniae (pneumococcus) historically caused up to 10% of infective endocarditis cases pre-antibiotics.
  • This association is now exceedingly rare in the current antibiotic era.

Purpose of the Study:

  • To report recent cases of pneumococcal endocarditis, particularly in elderly patients.
  • To assess the prevalence and outcomes of pneumococcal endocarditis, including prosthetic valve endocarditis (PVE).

Main Methods:

  • Retrospective case series of three patients diagnosed with S. pneumoniae endocarditis since 1997.
  • Literature review to identify additional cases of pneumococcal PVE.
  • Analysis of pneumococcal bacteremia data to estimate endocarditis prevalence.

Main Results:

  • Three elderly patients (>70 years) with S. pneumoniae endocarditis were treated successfully with antibiotics alone.
  • Pneumococcal endocarditis prevalence was 0.7% among patients >70 with pneumococcal bacteremia.
  • A literature review identified 16 additional PVE cases; overall, 76% of 17 patients survived, with 29% undergoing valve surgery.

Conclusions:

  • Pneumococcal endocarditis remains rare but treatable in the antibiotic era.
  • Outcomes are generally favorable, even in prosthetic valve endocarditis, with no evidence of increased virulence compared to other organisms.
Keywords:
Infective endocarditisMitral valve replacementProsthetic valve endocarditisStreptococcus pneumoniae

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