Infective endocarditis due to a rare pathogen, Streptococcus constellatus, in a patient with gingivitis: A case report and review of the literature

• Authors: Yusuke Yoshino , Yoshitaka Kimura , Takashi Sakai , Takeyuki Kanzaki , Kazunori Seo , Ichiro Koga , Takatoshi Kitazawa , Yasuo Ota
• Languages of publication: EN

Abstracts

EN

A 78-year-old Japanese man with a 5-day history of fever (∼38°C) and decreased appetite was admitted to our hospital. Transesophageal echocardiography revealed aortic valve vegetation. Streptococcus constellatus was detected from a blood culture. An antibiotic sensitive to this strain was administered for 6 weeks, and the patient has been well for 6 months without any sign of relapse. A review of all documented cases of infective endocarditis due to S. constellatus revealed nonspecific initial symptoms, especially coughing, and complications of abscess formation and septic embolisation. Clinicians should carefully consider the choice of antibiotic agents in the treatment of infective endocarditis due to S. constellatus, because penicillin-resistant strains have been documented in some cases.

Keywords

EN

Infective endocarditis; Streptococcus constellatus; Clinical features; Rare pathogenesis

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2013
• Volume: 8
• Issue: 4
• Pages: 489-492

Dates

published

1 - 8 - 2013

online

12 - 6 - 2013

Contributors

author

Yusuke Yoshino

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

author

Yoshitaka Kimura

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

author

Takashi Sakai

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

author

Takeyuki Kanzaki

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

author

Kazunori Seo

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

author

Ichiro Koga

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

author

Takatoshi Kitazawa

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

author

Yasuo Ota

• Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

References

• [1] Miro J.M., et al., Staphylococcus aureus native valve infective endocarditis: report of 566 episodes from the International Collaboration on Endocarditis Merged Database, Clin. Infect. Dis., 2005, 41, 507–514 http://dx.doi.org/10.1086/431979[Crossref]
• [2] McDonald J.R., et al., Enterococcal endocarditis: 107 cases from the international collaboration on endocarditis merged database, Am. J. Med., 2005, 118, 759–766 http://dx.doi.org/10.1016/j.amjmed.2005.02.020[Crossref]
• [3] Baddour L.M., et al., Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America, Circulation, 2005, 111, e394–e434 http://dx.doi.org/10.1161/CIRCULATIONAHA.105.165564[Crossref]
• [4] Kitada K., Inoue M., Kitano M., Experimental endocarditis induction and platelet aggregation by Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius, FEMS Immunol. Med. Microbiol., 1997, 19, 25–32 http://dx.doi.org/10.1111/j.1574-695X.1997.tb01069.x[Crossref]
• [5] Levin R.M., et al., Penicillin-resistant Streptococcus constellatus as a cause of endocarditis, Am. J. Dis. Child., 1982, 136, 42–45
• [6] Martin L., Gustaferro C., Chronic cough associated with subacute bacterial endocarditis, Mayo Clin. Proc., 1995, 70, 662–664 http://dx.doi.org/10.4065/70.7.662[Crossref]
• [7] Marinella M.A., Streptococcus constellatus endocarditis presenting as acute embolic stroke, Clin. Infect. Dis., 1997, 24, 1271–1272 http://dx.doi.org/10.1093/clinids/24.6.1271[Crossref]
• [8] Baran J., Jr., et al., Tricuspid valve endocarditis due to a moderately susceptible Streptococcus constellatus: persistent bacteremia and fatal outcome despite penicillin plus gentamicin therapy, Scand. J. Infect. Dis., 1998, 30, 420–421 http://dx.doi.org/10.1080/00365549850160765[Crossref]
• [9] Ejima K., et al., [Prosthetic valve endocarditis caused by Streptococcus constellatus infection complicated with perivalvular abscess: serial observation by transesophageal echocardiography: a case report], J. Cardiol., 2003, 42, 129–133
• [10] Batiste C., Bansal R.C., Razzouk A.J., Echocardiographic features of an unruptured mycotic aneurysm of the right aortic sinus of Valsalva, J. Am. Soc. Echocardiogr., 2004, 17, 474–477 http://dx.doi.org/10.1016/j.echo.2004.01.002[Crossref]
• [11] Tayama E., et al., Embolic myocardial infarction and left ventricular rupture due to mitral valve endocarditis, Ann. Thorac. Cardiovasc. Surg., 2007, 13, 206–208
• [12] Senses Z., et al., A rare pathogen causing endocarditis: Streptococcus constellatus, Anadolu. Kardiyol. Derg., 2008, 8, 315–316 [PubMed]
• [13] Wang’ondu R.W., Murray T.S., Relapse of polymicrobial endocarditis in an intravenous drug user, Yale J. Biol. Med., 2011, 84, 321–324
• [14] Concistre G., et al., Mitral and aortic valve endocarditis caused by a rare pathogen: Streptococcus constellatus, Interact. Cardiovasc. Thorac. Surg., 2012, 14, 889–890 http://dx.doi.org/10.1093/icvts/ivs032[Crossref][WoS]
• [15] Gossling J., Occurrence and pathogenicity of the Streptococcus milleri group, Rev. Infect. Dis., 1988, 10, 257–285 http://dx.doi.org/10.1093/clinids/10.2.257[Crossref]
• [16] Willcox M.D., Potential pathogenic properties of members of the “Streptococcus milleri” group in relation to the production of endocarditis and abscesses, J. Med. Microbiol., 1995, 43, 405–410 http://dx.doi.org/10.1099/00222615-43-6-405[Crossref]
• [17] Amal Mattu D.G., Barrett J.W., Broder J., DeAngelis M., Deblieux P., et al., In: Malden M. (Ed.) Emergency medicine: avoiding the pitfalls and improving the outcomes, Blackwell Pub./BMJ Books, 2007
• [18] Millaire A., et al., Obstruction of the left main coronary ostium due to an aortic vegetation: survival after early surgery, Clin. Infect. Dis., 1996, 22, 192–193 http://dx.doi.org/10.1093/clinids/22.1.192[Crossref]
• [19] Kitts D., Bongard F.S., Klein S.R., Septic embolism complicating infective endocarditis, J. Vasc. Surg., 1991, 14, 480–485; discussion 485–487 http://dx.doi.org/10.1016/0741-5214(91)90241-L[Crossref]
• [20] Lockhart P.B., et al., Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia, J. Am. Dent. Assoc., 2009, 140, 1238–1244 [Crossref]
• [21] Habib G., 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, 2369–2413 http://dx.doi.org/10.1093/eurheartj/ehp285[Crossref]

Identifiers

DOI

10.2478/s11536-013-0167-4