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A Rare Cause of Endocarditis: Streptococcus pyogenes

Ayşegül Yeşilkaya1, Ozlem Kurt Azap1, Bahar Pirat2

  • 1Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Başkent University, Ankara, Turkey.

Balkan Medical Journal
|September 11, 2014
PubMed

Insights

Group A Streptococcus endocarditis is rare but increasing. This case highlights Streptococcus pyogenes causing infective endocarditis in a healthy adult, requiring valve replacement and prolonged antibiotic therapy.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Group A Streptococcus (GAS), or Streptococcus pyogenes, is an uncommon cause of infective endocarditis.
  • Recent decades show an increasing incidence of invasive GAS infections, including bacteremia.
  • Prompt diagnosis and management are crucial for favorable outcomes.

Purpose of the Study:

  • To report a case of Streptococcus pyogenes infective endocarditis in a previously healthy adult.
  • To describe the clinical presentation, treatment, and outcome of this rare condition.

Main Methods:

  • Case report of a previously healthy adult presenting with fever.
  • Diagnostic workup including echocardiography to identify vegetations.
  • Treatment involved high-dose penicillin G, mechanical valve replacement, and a 6-week antibiotic course.

Main Results:

  • The patient developed Streptococcus pyogenes endocarditis, initially affecting the mitral valve.
  • New vegetation growth on the aortic valve was suspected during treatment.
  • Successful treatment involved surgical valve replacement and completion of antibiotic therapy.

Conclusions:

  • Streptococcus pyogenes can cause severe infective endocarditis even in healthy individuals.
  • Aggressive management, including surgical intervention and prolonged antibiotics, may be necessary.
  • This case underscores the importance of considering GAS in endocarditis etiology.
Keywords:
Group A β-hemolytic streptococcusendocarditis

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