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Streptococcus bovis Endocarditis after Colonic Polypectomy

Napohn Chongprasertpon1, Ronan Cusack1, J J Coughlan1

  • 1Department of Cardiology, University Hospital Limerick, Dooradoyle, Limerick, Ireland.

European Journal of Case Reports in Internal Medicine
|June 4, 2019
PubMed

Insights

A rare case of Streptococcus lutetiensis infective endocarditis occurred post-colonic polypectomy in a patient with mitral valve issues. Prompt treatment with antibiotics and surgery led to successful recovery.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Infective endocarditis (IE) is a serious infection of the heart valves.
  • Gastrointestinal endoscopy, including colonic polypectomy, can rarely lead to IE.
  • Patients with pre-existing heart conditions are at higher risk.

Purpose of the Study:

  • To report an uncommon case of IE caused by Streptococcus lutetiensis after colonic polypectomy.
  • To highlight the importance of clinical suspicion for IE in at-risk patients post-procedure.
  • To review the literature on Streptococcus bovis group IE.

Main Methods:

  • Case report detailing a patient's clinical presentation, diagnosis, and management.
  • Transoesophageal echocardiography for diagnosis.
  • Literature review of Streptococcus bovis group IE.

Main Results:

  • A patient developed IE due to Streptococcus lutetiensis following colonic polypectomy.
  • The patient had risk factors including mitral valve prolapse and regurgitation.
  • Diagnosis was confirmed by echocardiography showing a mitral valve mass.
  • Successful treatment involved intravenous antibiotics and mitral valve surgery.

Conclusions:

  • IE associated with gastrointestinal endoscopy is rare but warrants clinical suspicion, especially in high-risk patients.
  • Prophylactic antibiotics are not recommended for routine gastrointestinal endoscopic procedures.
  • Early diagnosis and appropriate management are crucial for favorable outcomes.
Keywords:
Infective endocarditisStreptococcus boviscolonic polypectomy

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