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Infective Endocarditis Caused by Streptococcus Sinensis in a Patient with Bioprosthetic Aortic Valve: A Case Report
Yannan Pan1,2, Jiandan Qian1, Guiqiang Wang1
1Department of Infectious Diseases, Peking University First Hospital, Beijing, People's Republic of China.
Background:
Infective endocarditis caused by Streptococcus sinensis is exceedingly rare, with only limited cases reported. Here, we present the first documented case of prosthetic valve endocarditis attributed to Streptococcus sinensis.
Case Presentation:
A 40-year-old Chinese female was admitted with a 45-day history of intermittent fever. The presumed diagnosis was a pulmonary infection and antibiotic therapies failed to alleviate her symptoms. On admission, infective endocarditis was suspected, considering the history of aortic valve replacement and recent dental procedure without prophylactic antibiotics. Transesophageal echocardiography disclosed a 3-millimeter vegetation in the prosthetic aortic valve, and metagenomic next-generation sequencing and mass spectrometry identified Streptococcus sinensis. The patient was diagnosed with infective endocarditis. Antibiotic treatments resulted in temporary clinical improvements, although fluctuations in temperature and inflammatory markers led to multiple attempts at antibiotic therapies. At last, the patient underwent an elective aortic valve replacement with a favorable prognosis.
Conclusion:
In this case, we demonstrated prosthetic valve endocarditis caused by Streptococcus sinensis, which is an extremely rare pathogen. All reported endocarditis cases caused by Streptococcus sinensis were reviewed and summarized. Most of these patients had rheumatic heart diseases or congenital heart diseases. Antibiotic prophylaxis is important for high-risk procedures. Timely identification of the bacterium is crucial for diagnosis and treatment. Overall, infective endocarditis caused by this bacterium had a good prognosis.
Insights
This case study details the first instance of prosthetic valve endocarditis caused by Streptococcus sinensis, an exceptionally rare bacterium. Prompt identification and treatment led to a favorable prognosis for the patient.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Infective endocarditis is a serious infection of the heart lining or valves.
- Streptococcus sinensis is a rare cause of infective endocarditis, with few cases reported globally.
- Prosthetic valve endocarditis presents unique diagnostic and management challenges.
Observation:
- A 40-year-old female with a history of aortic valve replacement presented with prolonged fever.
- Initial treatments for presumed pulmonary infection were ineffective.
- Transesophageal echocardiography revealed a vegetation on the prosthetic aortic valve.
Findings:
- Metagenomic next-generation sequencing and mass spectrometry identified Streptococcus sinensis as the causative agent.
- The patient was diagnosed with prosthetic valve endocarditis.
- Despite multiple antibiotic therapy attempts, surgical intervention (aortic valve replacement) was ultimately successful.
Implications:
- This case highlights Streptococcus sinensis as a potential pathogen in prosthetic valve endocarditis.
- Emphasizes the importance of timely and accurate microbiological identification for effective treatment.
- Reinforces the need for antibiotic prophylaxis in high-risk patients undergoing invasive procedures.
Related Concept Videos
01:25Endocarditis I: Introduction
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:18Endocarditis III: Medical Management
01:29Endocarditis IV: Nursing Management
01:21Myocarditis I: Introduction
01:23Rheumatic Heart Disease I: Introduction