Unusual Case Report of Infective Endocarditis Due to Streptococcus Agalactiae in Lebanon
-
Laurentia Fidella Averina Setia Santoso
,
Ribal Hassane Al Mokdad
,
Mustafa Saleh
,
Ahmad Mohamad Ezzedine
,
Mohammed Shawki Dabbous
Abstract
Background: Right-sided infective endocarditis (IE) is uncommon. Furthermore, Streptococcus agalactiae (S agalactiae) rarely causes IE, with only 2% to 9% of bacteremia cases manifesting as endocarditis.
Case Presentation: A 30-year-old Lebanese woman presented to the emergency department with high-grade fever and chills. Blood tests were obtained, urinalysis showed leukocytes, and treatment for urinary tract infection was initiated. The patient was hospitalized 3 days later and transferred to the ICU. Echocardiography revealed severe right-sided cardiomegaly, flail tricuspid leaflets with ruptured chordae, and a large coaptation defect. She was diagnosed with right-sided IE due to S agalactiae and underwent tricuspid valve replacement. Unfortunately, the patient died from acute decompensated heart failure.
Conclusion: This case represents an unusual instance of right-sided IE due to S agalactiae in Lebanon, for which definitive treatment guidance remains limited.
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11. Ya'qoub L, Rehan L, Parikh S, Enriquez J. Streptococcus Agalactiae Infective Endocarditis in a Healthy Middle-aged Man: Uncommon but Life-threatening. Cureus. 2018 May 16;10(5):e2632. doi: 10.7759/cureus.2632.
12. D’Angelo M, Boretti I, Quattrocchi S, Alongi G, Rifici C, Corallo F, et al. Lethal infective endocarditis due to Streptococcus agalactiae in a man with a history of alcohol abuse: A case report. Medicine (Baltimore) [Internet]. 2019 Dec;98(51):e18270.
13. Phokaphol K, Changpradub D. Right-sided infective endocarditis caused by Streptococcus agalactiae. J Infect Dis Antimicrob Agents. 2019;36(2):93-7.
14. Akinosoglou K, Apostolakis E, Marangos M, Pasvol G. Native valve right sided infective endocarditis. Eur J Intern Med. 2013 Sep 1;24(6):510-9.
15. Rollán MJ, San Román JA, Vilacosta I, Sarriá C, López J, Acuña M, et al. Clinical profile of streptococcus agalactiae native valve endocarditis. Am Heart J. 2003 Dec 1;146(6):1095-8.
16. Pettersson GB, Hussain ST. Current AATS guidelines on surgical treatment of infective endocarditis. Ann Cardiothorac Surg. 2019 Nov;8(6):630-44.
17. Wang A, Fosbøl EL. Current recommendations and uncertainties for surgical treatment of infective endocarditis: a comparison of American and European cardiovascular guidelines. Eur Heart J. 2022 May 1 ;43(17):1617-25.
18. Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, et al. 2020 ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Feb 2;143(5):e72-227.
19. Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015 Nov 21 ;36(44):3075-128.
20. Chioncel O, Adamo M, Nikolaou M, Parissis J, Mebazaa A, Yilmaz MB, et al. Acute heart failure and valvular heart disease: A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology. Eur J Heart Fail. 2023;25(7):1025-1048.
2. El-Chakhtoura N, Yasmin M, Kanj SS, Baban T, Sfeir J, Kanafani ZA. A 27-year experience with infective endocarditis in Lebanon. J Infect Public Health. 2017 Nov 1 ;10(6):734-9.
3. Shmueli H, Thomas F, Flint N, Setia G, Janjic A, Siegel RJ. Right‐Sided Infective Endocarditis 2020: Challenges and Updates in Diagnosis and Treatment. J Am Heart Assoc. 2020 Aug 4 ;9(15):e017293.
4. Machado C, Almeida C, Santos E, Pelicano N, Dourado R, Martins D. Streptococcus agalactiae endocarditis. Rev Port Cardiol Engl Ed. 2012 Sep 1;31(9):619-21.
5. Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM). Eur Heart J. 2023 Oct 14;44(39):3948-4042.
6. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, 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). Eur Heart J. 2009 Oct 1;30(19):2369-413.
7. Amico S, Calvo L, Corrao S. An “aubergine” in the heart: huge native mitral valve endocarditis caused by Streptococcus agalactiae. Intern Emerg Med. 2018 Jan 1;13(1):137-8.
8. Shrestha DB, Shtembari J, Sowunmi L, Adhikari A, Joshi T. Streptococcus agalactiae as a Primary Cause of Infective Endocarditis with Septic Emboli in an Undiagnosed Rheumatic Mitral Stenosis Patient: An Encounter in a US-Based Safety-Net Hospital. Cureus. 2023 Apr 18;15(4):e37802. doi: 10.7759/cureus.37802.
9. Wang R, Cao X, Wu F, Zhao J, Fu L, Yuan Z, Ni Y, Chen Z, Li F. Infectious native valve endocarditis by Streptococcus agalactiae species: Case report of pathogen identification only through metagenomic sequencing technology. Medicine (Baltimore). 2022 Jul 8;101(27):e29360. doi: 10.1097/MD.0000000000029360.
10. Achilli P, Guttadauro A, Bonfanti P, Terragni S, Fumagalli L, Cioffi U, Gabrielli F, De Simone M, Chiarelli M. Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic aneurysms and massive splenic infarction: a case report. BMC Gastroenterol. 2017 Dec 29;17(1):170. doi: 10.1186/s12876-017-0728-0.
11. Ya'qoub L, Rehan L, Parikh S, Enriquez J. Streptococcus Agalactiae Infective Endocarditis in a Healthy Middle-aged Man: Uncommon but Life-threatening. Cureus. 2018 May 16;10(5):e2632. doi: 10.7759/cureus.2632.
12. D’Angelo M, Boretti I, Quattrocchi S, Alongi G, Rifici C, Corallo F, et al. Lethal infective endocarditis due to Streptococcus agalactiae in a man with a history of alcohol abuse: A case report. Medicine (Baltimore) [Internet]. 2019 Dec;98(51):e18270.
13. Phokaphol K, Changpradub D. Right-sided infective endocarditis caused by Streptococcus agalactiae. J Infect Dis Antimicrob Agents. 2019;36(2):93-7.
14. Akinosoglou K, Apostolakis E, Marangos M, Pasvol G. Native valve right sided infective endocarditis. Eur J Intern Med. 2013 Sep 1;24(6):510-9.
15. Rollán MJ, San Román JA, Vilacosta I, Sarriá C, López J, Acuña M, et al. Clinical profile of streptococcus agalactiae native valve endocarditis. Am Heart J. 2003 Dec 1;146(6):1095-8.
16. Pettersson GB, Hussain ST. Current AATS guidelines on surgical treatment of infective endocarditis. Ann Cardiothorac Surg. 2019 Nov;8(6):630-44.
17. Wang A, Fosbøl EL. Current recommendations and uncertainties for surgical treatment of infective endocarditis: a comparison of American and European cardiovascular guidelines. Eur Heart J. 2022 May 1 ;43(17):1617-25.
18. Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, et al. 2020 ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Feb 2;143(5):e72-227.
19. Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015 Nov 21 ;36(44):3075-128.
20. Chioncel O, Adamo M, Nikolaou M, Parissis J, Mebazaa A, Yilmaz MB, et al. Acute heart failure and valvular heart disease: A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology. Eur J Heart Fail. 2023;25(7):1025-1048.
| Files | ||
| Issue | Vol 20 No 3 (2025) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/jthc.v20i3.20116 | |
| Keywords | ||
| Streptococcus Agalactiae Infective Endocarditis Case Report | ||
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How to Cite
1.
Setia Santoso LFA, Al Mokdad RH, Saleh M, Ezzedine AM, Dabbous MS. Unusual Case Report of Infective Endocarditis Due to Streptococcus Agalactiae in Lebanon. Res Heart Yield Transl Med. 2024;20(3):242-248.
