Invasive pyogenic infection and infective endocarditis due to Streptococcus anginosus: A case report

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 × 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 prolo...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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Rationale: Rituximab is recommended to induce remission of severe granulomatosis with polyangiitis (GPA). Plasma exchange (PE) may be considered in the setting of rapidly progressive glomerulonephritis (RPGN) with a serum creatinine increase of more than 5.6 mg/dl or diffuse alveolar hemorrhage (DAH). However, there are no sufficient studies on combination therapy with rituximab and PE in GPA. Patient concerns: A 23-year-old woman was admitted with fever, abdominal pain, and diarrhea on suspicion of infectious colitis. Colonoscopy showed hemorrhagic colitis and antibiotic treatment was ineffective. Physical examinat...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract Osteoarticular infections (OAIs) in the setting of infective endocarditis (IE) are uncommon. Although morbidity and mortality have been widely studied, details of the characteristics of patients with concurrent IE and OAI are limited. Therefore, the purpose of this study was to determine the (1) incidence, (2) mortality, (3) clinical features, and (4) microbiological profiles of OAIs in the setting of IE. A retrospective review was conducted of 1280 IE cases at a large academic institution between 2009 and 2015. Patients were categorized according to the following OAI types: spondylodiskitis, large joint ...
Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research
CONCLUSIONS: The clinical profile, pathogen types, and the management strategies in Polish patients with CDRIE are consistent with similar data from other European countries . Transoesophageal echocardiography was performed less frequently than is recommended.. Percutaneous approach was most commonly used for cardiac device removal. The removal rate in Polish patients with CDRIE is consistent with real capabilities of treatment in patients with CDRIE. PMID: 31066721 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
Publication date: Available online 23 April 2019Source: Interdisciplinary NeurosurgeryAuthor(s): Kyle P. O'Connor, Gina S. Perez, Bappaditya Ray, Jo Elle G. Peterson, Bradley N. BohnstedtAbstractA 62-year-old woman with history of chronic back pain and vertebral osteomyelitis presented with right hemiparesis and aphasia with last known well 10 h prior to presentation and a CT angiography demonstrating a left M1 occlusion. A thrombectomy was performed with resultant TICI-2b improving NIHSS from 28 pre-thrombectomy to 19 post-thrombectomy. Pathologic examination of the embolus demonstrated abundant bacterial colonies. Whil...
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
Authors: Aoyama Y, Oba Y, Hoshide S, Arai Y, Komori T, Kabutoya T, Kario K Abstract A 68-year-old Japanese man was admitted to our hospital with right eye pain, a sudden worsening of his eyesight, and a fever. He was diagnosed with endogenous bacterial endophthalmitis due to infectious endocarditis (IE) of Group B Streptococcus (GBS) on the day of admission. He recovered systemically, but his right eye became phthisical only with the administration of antibiotics. We conducted a review of the reported cases of IE caused by GBS complicated with endogenous bacterial endophthalmitis. IE should be considered when an un...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Conclusions: The existence of pulmonary embolism simulating pneumonia was the first clue to diagnosis of IE in IDU. Echo detected the vegetations on tricuspid valve and confirmed the diagnosis. The pulmonary onset and PC knowledge of IDU IE is important for early diagnostics in any clinical department of a modern hospital.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary embolism Source Type: research
A 28-year-old man underwent total correction of tetralogy of Fallot in 2003. He was diagnosed with infective endocarditis 2 months before and received treatment in a cardiac unit. After discharge, he developed periumbilical pain associated with early satiety and decreased appetite.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
“Good morning, Mr. S! How are you feeling today?” I ask as I step into his hospital room. Yesterday, Mr. S was admitted for infective endocarditis and has been tolerating antibiotic treatment well. I am a medical student on my acute cardiology rotation taking care of him. “I’m feeling fine,” he says, and I proceed to ask about how he slept, if he’s experiencing any chest pain, palpitations, shortness of breath, abdominal pain, or problems going to the bathroom. He seems to have all these answers memorized, saying no to my questions. I perform a physical exam and decide that he is doing a...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Education Cardiology Hospital-Based Medicine Source Type: blogs
Long and Koyfman have highlighted the acute presentation of infective endocarditis (IE) in intravenous drug users [1]. The acute presentation includes a range of pulmonary stigmata which may dominate the clinical picture almost to the exclusion of an index of suspicion for IE. Those stigmata include chest pain, cough, haemoptysis, pulmonary infarction, lung abscess, pleural effusion, and empyema, respectively, all ultimately attributable to septic emboli [2]. Another acute presentation is the one characterised by acute left ventricular failure and severe breathlessness as a result of IE-related acute aortic valve regurgitation.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Publication date: Available online 11 July 2018Source: IDCasesAuthor(s): Seok Mei Lim, Beatrix Wong, Gail Brenda Cross, Reshma MerchantAbstractAn 85-year-old man with a history of aortic valve replacement presented with lower limb cramps. He was initially diagnosed with degenerative disc disease, but was found to have Lactococcus garvieae infective endocarditis with septic embolic strokes causing a central poststroke pain syndrome. Cardiothoracic surgery was deemed too high risk and the patient completed 6 weeks of intravenous antimicrobials as well as prolonged inpatient rehabilitation. Lactococcus garvieae is an aquacult...
Source: IDCases - Category: Infectious Diseases Source Type: research
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