Rare Simultaneous Left and Right-Sided Native Valve Infective Endocarditis Caused by Rare Bacterium

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Case Reports

Background:

• Simultaneous left and right-sided native valve infective endocarditis (IE) is uncommon.
• Staphylococcus aureus and shunt diseases are typical causes and risk factors, respectively.
• Streptococcus anginosus typically causes pyogenic infections and rarely infective endocarditis.

Observation:

• A 66-year-old male presented with prolonged constitutional symptoms including fatigue, chills, and intermittent fevers.
• Physical examination revealed systolic murmurs at the mitral and tricuspid areas.
• Laboratory tests showed elevated inflammatory markers and hyperglycemia; blood cultures identified Streptococcus anginosus.

Findings:

• Echocardiography confirmed large vegetations on both the mitral and tricuspid valves, leading to severe mitral regurgitation and moderate tricuspid regurgitation.
• This represents an exceptionally rare case of simultaneous bilateral native valve IE caused by S. anginosus in an adult.
• The patient lacked common predisposing factors for IE, such as shunt diseases.

Implications:

• This case underscores the importance of considering less common pathogens like S. anginosus in the etiology of bilateral IE.
• It highlights a rare clinical presentation of S. anginosus infection.
• The findings emphasize the diagnostic value of echocardiography in identifying complex IE cases and the need for vigilance even in the absence of typical risk factors.