J Cardiovasc Ultrasound.  2011 Mar;19(1):38-40. 10.4250/jcu.2011.19.1.38.

Infective Endocarditis due to Streptococcus Agalactiae in Young and Immunocompetent Woman: A Case of Structurally Normal Valve Endocarditis Presented with Major Stroke

• Song MJ
• Kim WH
• Lee SH
• Lee SR
• Rhee KS
• Chae JK
• Ko JK

• KMID: 2135432
• DOI: http://doi.org/10.4250/jcu.2011.19.1.38

Abstract

We describe here a 26-year-old woman who presented confusion and right hemiparesis due to embolic obstruction of left internal carotid artery and middle cerebral artery. Transthoracic echocardiography showed structurally normal mitral valve with hypermobile echogenic material suggesting vegetation. The vegetation was disappeared after antimicrobial treatment without surgery.

Keyword

Embolic obstruction; Vegetation; Normal valve

MeSH Terms

Adult
Carotid Artery, Internal
Echocardiography
Endocarditis
Female
Humans
Middle Cerebral Artery
Mitral Valve
Paresis
Streptococcus
Streptococcus agalactiae
Stroke

Figure

• 

  Fig. 1 Cerebral angiography shows complete thrombotic obstruction at the distal portion of left ICA (A). Final angiography after percutaneous thrombolysis shows good patency of left MCA, ACA and ICA (B). Brain MRI shows acute infarction in left MCA territory (circle) and focal hemorrhage in left lentiform nucleus (arrow) (C). ICA: internal carotid artery, MCA: middle cerebral artery, ACA: anterior cerebral artery, MRI: magnetic resonance imaging.

• 

  Fig. 2 Transthoracic echocardiography shows 0.8 × 0.5 cm-sized, echogenic and hypermobile mass on PMVL (A). Follow-up after antimicrobial therapy, echogenic mass was disappeared compared with previous study (B). Transthoracic echocardiography shows structurally normal MV during the end-systolic phase (C). PMVL: posterior mitral valve leaflet, MV: mitral valve.

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