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Streptococcus milleri endocarditis complicated by myocardial abscess.

R A Levandowski

    Southern Medical Journal
    |July 1, 1985
    PubMed
    Summary

    Streptococcus milleri endocarditis can cause cardiac abscesses. Surgical intervention and penicillin therapy achieved a cure, with gentamicin showing no added benefit in this case.

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    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Microbiology

    Background:

    • Endocarditis is a serious infection of the heart lining.
    • Streptococcus milleri, an alpha-hemolytic streptococcus, can cause invasive infections.
    • Cardiac abscesses are a rare but severe complication of endocarditis.

    Observation:

    • A patient presented with Streptococcus milleri endocarditis and a myocardial abscess.
    • The patient underwent surgical intervention.
    • Treatment included parenteral penicillin and gentamicin therapy.

    Findings:

    • Bacteriological cure was achieved after surgery and antibiotic treatment.
    • In vitro studies of the bacterial isolate indicated that gentamicin provided no additional therapeutic advantage.
    • The case highlights that S. milleri can lead to local cardiac suppurative complications.

    Implications:

    • Speciation of alpha-hemolytic streptococci may aid in guiding antimicrobial susceptibility testing.
    • Aggressive management including surgery and appropriate antibiotics is crucial for S. milleri endocarditis with abscess.
    • This case contributes to understanding the clinical spectrum of S. milleri infections.

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