Right-sided native-valve infective endocarditis caused by Streptococcus acidominimus: A case report

Liyana Arachchige Dona Thulini Madubashini1, Jayawardane Pathiranage Roneesha Lakmali1, Chandrasiri N Shirani2

  • 1Professorial Medicine Unit, Colombo South Teaching Hospital, Kalubowila, Dehiwala, Sri Lanka.

Insights

This case report details a rare instance of Streptococcus acidominimus causing right-sided infective endocarditis. The pathogen was sensitive to beta-lactams, contrasting with typical resistance patterns.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Streptococcus acidominimus is an uncommon cause of human infection, with few documented cases.
  • Published literature on infective endocarditis (IE) due to S. acidominimus is scarce, predominantly reporting left-sided disease.
  • S. acidominimus is increasingly recognized for its resistance to beta-lactam antibiotics.

Observation:

  • A 52-year-old male with congenital heart disease presented with symptoms suggestive of infective endocarditis.
  • Diagnostic workup revealed right-sided native-valve infective endocarditis.
  • Cultures identified Streptococcus acidominimus as the causative agent.

Findings:

  • This case represents the first reported instance of infective endocarditis caused by S. acidominimus in Sri Lanka.
  • Unlike previously reported cases, the isolated S. acidominimus strain demonstrated sensitivity to beta-lactam antibiotics.
  • The patient's underlying congenital heart disease likely predisposed him to right-sided endocarditis.

Implications:

  • This case expands the spectrum of clinical presentations for S. acidominimus infections.
  • The observed beta-lactam sensitivity in this case challenges the emerging trend of resistance, suggesting variability in antimicrobial susceptibility.
  • Highlights the importance of considering rare pathogens and performing susceptibility testing in infective endocarditis, particularly in patients with complex cardiac conditions.

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