Group B streptococcal endocarditis involving the tricuspid valve in a 7-month-old infant

To our knowledge, we report the first case of group B streptococcal endocarditis that occurred in an infant after the neonatal period. A large, friable vegetation had destroyed the tricuspid valve and resulted in pulmonary emboli. Surgical resection of the valve was needed to achieve clinical cure of the patient. A review of the English-language literature on older patients with group B streptococcal endocarditis revealed a mortality rate of 60% among patients treated with antimicrobial drugs alone and a mortality rate of 29% among those whose treatment included both surgery and therapy with antimicrobial drugs. Surgical debridement of the valve may be necessary for children with large vegetations, which tend to embolize and thus contribute to the morbidity and mortality associated with group B streptococcal endocarditis.