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08:25

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Published on: April 7, 2015

A Case Report: Mitral Valve Infective Endocarditis due to Streptococcus mitis With Cardioembolic Stroke in the

Thuy Hao Nguyen1, Mahpara Munir2, Ngoc Thai Kieu2

  • 1Internal Medicine, Hurley Medical Center/Michigan State University, Flint, Michigan, USA, hurleymc.com.

Case Reports in Cardiology
|July 26, 2026
PubMed

Insights

Gastrointestinal issues like bowel obstruction and neuroendocrine tumors may lead to infective endocarditis (IE) when the infection source is unknown. Further research is needed to confirm this link in patients with unexplained bacteremia.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Gastroenterology

Background:

  • Infective endocarditis (IE) is a severe infection of the heart lining.
  • Bacteremia, often from oral or intravascular sources, typically causes IE.
  • The gastrointestinal (GI) tract's role in unexplained IE cases is not fully understood.

Purpose of the Study:

  • To present a case of infective endocarditis potentially linked to an unidentified gastrointestinal pathology.
  • To highlight the need for considering GI evaluation in patients with IE and no clear source of infection.

Main Methods:

  • Case report of a patient in her 70s with comorbidities presenting with IE symptoms.
  • Diagnostic workup included blood cultures, echocardiography, and brain MRI.
  • Abdominal symptoms led to further GI evaluation, revealing fecal impaction and an ileal neuroendocrine tumor.

Main Results:

  • Patient diagnosed with infective endocarditis caused by Streptococcus mitis, with mitral valve vegetation.
  • Brain imaging showed multiple acute cardioembolic infarctions.
  • Undiagnosed ileal neuroendocrine tumor with liver lesions and severe fecal impaction were identified as potential, albeit unproven, bacteremia sources.

Conclusions:

  • Gastrointestinal pathology, including malignancy and bowel dysfunction, may be an underrecognized source of bacteremia leading to IE.
  • In IE cases with unidentified bacteremia sources, a targeted GI evaluation might be beneficial.
  • Further studies are necessary to establish the causal relationship between GI pathology and infective endocarditis.

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