Infect Chemother.  2006 Oct;38(5):271-276.

Two Cases of Infective Endocarditis with Multiple Brain Infarcts Caused by Streptococcus agalactiae

• Park J
• Choi SN
• Kim HO
• Jeong YG
• Hwang JY
• Kim JW
• Bae IG

Abstract

The higher incidence of Streptococcus agalactiae infection in the newborns and pregnant women had been well recognized. The incidence of invasive S. agalactiae infection was recently increasing in both elderly adults and those with comorbid conditions such as diabetes mellitus, liver cirrhosis, malignancy, and abnormalities in immune responses. We report our experience with two diabetic middle-aged men who suffered from S.agalactiae infective endocarditis. Case 1) A 58-year-old man with diabetes mellitus and chronic alcoholism presented with fever and both lower legs weakness. An echocardiography showed two vegetations on the mitral valve. S. agalactiae was identified from blood cultures. He was treated with penicillin G and gentamicin, and he underwent mitral valve replacement surgery because of persistent fever and newly developed brain infarcts. One month later, an amputation of the left lower leg was performed for the embolic gangrene of left lower leg. Case 2) A 57-year-old diabetic man was admitted to our hospital because of fever and left shoulder pain. He had received the incision and drainage to treat left shoulder joint septic arthritis, but he had a continuous fever. On 5th day of admission, culture of pus from the left shoulder joint revealed S. agalactiae. An echocardiography showed a vegetation on the posterior mitral leaflet. He was treated with penicillin G and gentamicin. On 18th day of admission, a mitral valve replacement surgery was performed. He was discharged without recurrence.

Keyword

Streptococcus agalactiae; Infective endocarditis; Cerebral embolism

MeSH Terms

Adult
Aged
Alcoholism
Amputation
Arthritis, Infectious
Brain*
Diabetes Mellitus
Drainage
Echocardiography
Endocarditis*
Female
Fever
Gangrene
Gentamicins
Humans
Incidence
Infant, Newborn
Intracranial Embolism
Leg
Liver Cirrhosis
Male
Middle Aged
Mitral Valve
Penicillin G
Pregnant Women
Recurrence
Shoulder Joint
Shoulder Pain
Streptococcus agalactiae*
Streptococcus*
Suppuration
Gentamicins
Penicillin G