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Streptococcus pneumoniae endocarditis presenting as an epidural abscess
R Clark1, J T Carlisle, G T Valainis
1Infectious Diseases Section, Tulane University Medical School, New Orleans, Louisiana 70112.
Abstract:
Streptococcus pneumoniae is an important pathogen in many serious infections, such as pneumonia, sinusitis, and meningitis. It uncommonly causes infective endocarditis and only rarely produces spinal epidural abscesses. This report describes a patient who had pneumococcal infection presenting as an acute epidural abscess and who was subsequently found to have endocarditis. S. pneumoniae was cultured from both blood and abscess material. A high level of clinical suspicion of endocarditis is important in all cases of bacteremic pneumococcal illness; patients with such an illness and back pain may harbor potentially catastrophic epidural abscesses.
Insights
Streptococcus pneumoniae rarely causes spinal epidural abscesses and infective endocarditis. This case highlights the importance of suspecting endocarditis in bacteremic pneumococcal illness, especially with back pain, to identify potential epidural abscesses.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Medicine
Background:
- Streptococcus pneumoniae is a common cause of pneumonia, sinusitis, and meningitis.
- Pneumococcal infective endocarditis and spinal epidural abscesses are rare complications.
Observation:
- This report details a patient with pneumococcal infection initially presenting as an acute epidural abscess.
- The patient was later diagnosed with concurrent infective endocarditis.
Findings:
- Streptococcus pneumoniae was successfully cultured from both blood and abscess samples.
- This case underscores the association between bacteremic pneumococcal illness and serious complications.
Implications:
- High clinical suspicion for endocarditis is crucial in all bacteremic pneumococcal infections.
- Patients with pneumococcal bacteremia and back pain require thorough evaluation for epidural abscesses.
- Prompt diagnosis and treatment of these rare but severe conditions are vital.