標題: Invasive pyogenic infection and infective endocarditis due to Streptococcus anginosus A case report
作者: Cheng, Chiao-Wen
Feng, Cheng-Min
Chua, Chian Sem
運輸與物流管理系 註:原交通所+運管所
Department of Transportation and Logistics Management
關鍵字: brain microabscess;infective endocarditis;mitral valve prolapse;renal embolization;Streptococcus anginosus
公開日期: 1-Nov-2019
摘要: Rationale: Streptococcus anginosus mostly colonizes the digestive and genitourinary system, including the oropharyngeal region. It commonly causes invasive pyogenic infection, but less likely causes infective endocarditis (IE). Patient concerns: An 18-year-old woman who had an underlying mitral valve prolapse without mitral regurgitation presented to our hospital with low-grade fever, left leg weakness, and left abdominal pain. She was diagnosed with brain infarction and microabscess as well as IE. The patient totally recovered after the 6-week course of intravenous antibiotics. Diagnosis: Brain magnetic resonance imaging revealed brain infarction and microabscess. Abdominal computed tomography revealed splenic and left renal infarction. Three sets of blood culture were positive for S anginosus. Transthoracic echocardiogram identified mitral valve prolapse with moderate eccentric mitral valve regurgitation, and a 0.3 x 0.6-cm vegetation was found on the left mitral valve. All of these results meet the modified Duke criteria. Interventions: The abdominal pain and left leg weakness were improving after 2 weeks of intravenous antibiotics treatment. No neurological sequelae were noted after completing the 6-week course of medical treatment. Outcomes: The patient was successfully treated and discharged after completing the 6-week intravenous antibiotics treatment. Lessons: IE should be considered in young patients with native valve disease who have prolonged fever. Though S anginosus commonly causes invasive pyogenic infection, patients with native valve disease should be checked for IE.
URI: http://dx.doi.org/10.1097/MD.0000000000018156
http://hdl.handle.net/11536/153788
ISSN: 0025-7974
DOI: 10.1097/MD.0000000000018156
期刊: MEDICINE
Volume: 98
Issue: 48
起始頁: 0
結束頁: 0
Appears in Collections:Articles