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Viridans streptococcal endocarditis
Abstract:
Although responsible for a declining proportion of cases of infective endocarditis, viridans streptococci remain the commonest cause and accounted for 30% of our cases seen in Huntsville, Alabama. Usually viridans streptococcal endocarditis is associated with dental manipulation or infection and underlying heart disease but both conditions were not common in our series. Similar to the experience of other investigators, our patients exhibited a subacute course with fever, dyspnea, weight loss and heart murmur. Echocardiography, reported useful in detecting vegetations in one series, was not a sensitive diagnostic tool in our patients. We confirmed the low relapse rate and mortality rate associated with earlier reports of viridans streptococcal endocarditis but observed a high rate of complications, as noted in a recent series.
Insights
Viridans streptococci are the most frequent cause of infective endocarditis, often presenting subacutely. Despite low relapse and mortality, complications remain a concern in these infections.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Viridans streptococci are the most common cause of infective endocarditis.
- This study examines cases in Huntsville, Alabama, noting a 30% proportion.
Purpose of the Study:
- To characterize the clinical presentation, diagnosis, and outcomes of viridans streptococcal endocarditis.
- To assess the role of echocardiography in diagnosing vegetations.
Main Methods:
- Retrospective case series analysis.
- Clinical data review including patient history, symptoms, and diagnostic findings.
Main Results:
- Subacute presentation with fever, dyspnea, weight loss, and heart murmur was typical.
- Echocardiography showed limited sensitivity for vegetation detection in this series.
- Low relapse and mortality rates were confirmed, but complications were frequent.
Conclusions:
- Viridans streptococcal endocarditis often presents atypically without common predisposing factors.
- While outcomes are generally favorable regarding relapse and mortality, vigilance for complications is crucial.
- Further research into optimal diagnostic and management strategies is warranted.