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An Autopsy Case of Streptococcus dysgalactiae subsp. equisimilis Infectious Endocarditis Accompanied by Streptococcal
Ayaho Tsujino1, Aki Nakajima1, Haruka Yabuta2
1Center of Medical Education and Training, Minami-Nara General Medical Center, Japan.
Abstract:
A 66-year-old woman with liver cirrhosis and hemodialysis was referred with a 1-week history of pain and rash on the left lower leg. On an examination, the patient was in shock. She was administered catecholamine support for septic shock and ampicillin/sulbactam for severe cellulitis. Streptococcus dysgalactiae subsp. equisimilis (SDSE) was isolated from the blood culture, and she was diagnosed with streptococcal toxic shock syndrome. Despite therapy, the patient died on day 7 of admission. Infective endocarditis (IE) was diagnosed during an autopsy. Clinicians should be aware that overwhelming SDSE-IE can occur even in the absence of necrotizing fasciitis, especially in immunocompromised patients.
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