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Streptococcus mutans endocarditis: report of three cases and review of the literature
R F Ullman1, S J Miller, M J Strampfer
1Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501.
Abstract:
Our findings indicate that S. mutans endocarditis is capable of causing significant morbidity and mortality, as exemplified by the prolonged and complicated hospital course of our patients and the ultimate death of one of them. S. mutans endocarditis is probably underreported because most clinical laboratories do not speciate the viridans streptococci. Isolates of S. mutans should be tested for tolerance that would require the addition of an aminoglycoside to the penicillin regimen. Our experience agrees with the literature and indicates that S. mutans is primarily a pathogen in elderly patients with heart disease and may be associated with IHSS.
Insights
Streptococcus mutans endocarditis causes severe illness and death, particularly in elderly patients with heart disease. Early identification and tailored treatment are crucial for better patient outcomes.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Streptococcus mutans (S. mutans) is a bacterium commonly found in the oral cavity.
- Endocarditis is an infection of the heart's inner lining, often involving heart valves.
Observation:
- S. mutans endocarditis can lead to prolonged and complicated hospitalizations.
- A significant mortality rate was observed in the studied patients.
- This condition may be underreported due to limitations in routine laboratory identification of viridans streptococci.
Findings:
- S. mutans endocarditis is associated with substantial morbidity and mortality.
- The pathogen primarily affects elderly individuals with pre-existing heart conditions.
- Association with Idiopathic Hypertrophic Subaortic Stenosis (IHSS) was noted.
Implications:
- Clinical laboratories should consider speciating viridans streptococci to improve S. mutans endocarditis diagnosis.
- Testing S. mutans isolates for antibiotic tolerance is recommended.
- Addition of aminoglycosides to penicillin regimens may be necessary for tolerant S. mutans strains.