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Endocarditis caused by unusual Streptococcus species (Streptococcus pluranimalium)

A Fotoglidis1, E Pagourelias1, P Kyriakou1

  • 13 Cardiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Hippokratia
|July 16, 2016
PubMed
Abstract

Insights

A rare Streptococcus infection caused severe infective endocarditis in an intravenous drug abuser, leading to rapid disease progression and death despite treatment. This highlights evolving microbial threats in this patient population.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Infective endocarditis (IE) in intravenous drug abusers (IDUs) typically involves Staphylococcus species and affects right-sided heart valves.
  • The microbiological landscape of IE in IDUs is evolving, presenting new challenges in diagnosis and treatment.

Observation:

  • A case of a 37-year-old intravenous drug abuser with IE affecting the mitral and aortic valves is presented.
  • An unusual Streptococcus species, Streptococcus pluranimalium, isolated from surgical specimens, is implicated.
  • This organism, typically associated with animal diseases, had no prior reported human infections.

Findings:

  • The infection manifested as large mitral valve vegetations (>2cm), smaller aortic valve vegetations, and systemic emboli.
  • The Streptococcus pluranimalium infection demonstrated resistance to antimicrobial therapy and rapid disease progression.
  • Despite medical management and surgical valve replacement, the patient died two months after initial presentation.

Implications:

  • This case underscores the emergence of unusual pathogens in infective endocarditis among intravenous drug abusers.
  • Clinicians must consider atypical microbiological profiles and clinical presentations in IDUs with IE.
  • Reevaluation of medical management strategies is crucial for these complex and often fatal cases.
Keywords:
Streptococcus pluranimaliumdrug abuserinfective endocarditis

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