Bahadır GÜLTEKİN, Bahar PİRAT, Özlem AZAP KURT, Hande ARSLAN, Ayşegül YEŞİLKAYA

A rare cause of endocarditis: Streptococcus pyogenes

Although group A β-hemolytic streptococcus is an uncommon cause of infective endocarditis, an increase in the incidence of invasive group A streptococcus infections including bacteremia has been reported in the last two decades. Herein we report Streptococcus pyogenes endocarditis in a previously healthy adult patient who was hospitalized to investigate the etiology of fever. Because of a suspicion of a new vegetation appeared in the second (aortic) valve in the 14th day of high dose penicillin G treatment, the mitral and aortic valves were replaced by mechanical prosthesis on the 22nd day of treatment. He was discharged from hospital after the 6 week course of antibiotic treatment.

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1. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J 2009;30:2369-413. [CrossRef]
2. Burkert T, Watanakunakorn C. Group A streptococcus endocarditis: report of five cases and review of literature. J Infect 1991;23:307-16. [CrossRef]
3. Branch J, Suganami Y, Kitagawa I, Stein GH, Tanaka E. A rare case of Group A Streptococcal endocarditis with absence of valvular vegetation. Inter Med 2010;49:1657-61. [CrossRef]
4. Lefort A, Lortholary O, Casassus P, Selton-Suty C, Guillevin L, Mainardi JL. Comparison between adult endocarditis due to β-hemolytic Streptococci (serogroups A, B, C, and G) and Streptococcus milleri. Arch Intern Med 2002;162:2450-6. [CrossRef]
5. Roca B, Marco JM. Presentation and outcome of infective endocarditis in Spain: a retrospective study. Int J Infect Dis 2007;11:198-203. [CrossRef]
6. Winterbotham A, Riley S, Kavanaugh-McHugh A, Dermody TS. Endocarditis caused by group A beta-hemolytic Streptococcus in an infant: case report and review. Clin Infect Dis 1999;29:196-8. [CrossRef]
7. Mohan UR, Walters S, Kroll JS. Endocarditis due to group A β-hemolytic Streptococcus in children with potentially lethal sequelae: 2 cases and review. Clin Infect Dis 2000;30:624-5. [CrossRef]
8. Benes J, Picha D, Kabelkova M, Dzupova O, Horova B, Gabrielova A. Infective endocarditis caused by unusual gram-positive pathogens. Folia Microbiol 2002;47:737-41. [CrossRef]
9. Laskey AL, Johnson TR, Dagartzikas MI, Tobias JD. Endocarditis attributable to group A β-hemolytic streptococcus after uncomplicated varicella in a vaccinated child. Pediatrics 2000;106:E40. [CrossRef]
10. Ozdemir N, Kaymaz C, Ozkan M. An unusual image within the left atrium with UFO-like appearance on transoesophageal echocardiography. Heart 2002;88:633. [CrossRef]
11. Baddour LM. Infective endocarditis caused by beta-hemolytic streptococci. The Infectious Diseases Society of America’s Emerging Infections Network. Clin Infect Dis 1998;26:66-71. [CrossRef]