1887

Abstract

Introduction:

Group B (GBS) is a rare infectious endocarditis. Patients with GBS infective endocarditis have a high rate of local and systemic complications.

Case presentation:

A 30-year-old male presented to the Emergency Department with fever, chills, fatigue and a recent onset of symptoms suggestive of stroke following a bout of pyelonephritis. Echocardiography confirmed a diagnosis of endocarditis and blood cultures grew GBS. Antibiotic therapy was initiated with penicillin G and gentamicin. Urological evaluation revealed a urethral stricture. He was taken to the operating room on hospital day 10 for the debridement of his aortic annulus, reconstruction of his aortic root and replacement of his aortic valve. On post-operative day 7, he died of sudden cardiac arrest. A large myocardial abscess located within the interventricular septum was identified post-mortem.

Conclusion:

Recurrent or complicated urinary tract infections are rare among the young male population. Without evaluation and treatment for the underlying pathology, patients are at risk of developing antimicrobial-resistant infections, which may disseminate rapidly. Although a common pathogen of the urinary tract, GBS is a rare infectious agent for endocarditis. We propose urethral stricture as a risk factor for developing GBS endocarditis. Operative timing for these infections can be challenging; however, urgent and radical surgical debridement appears to yield favourable results.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.000047
2015-08-01
2024-12-08
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/2/4/jmmcr000047.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.000047&mimeType=html&fmt=ahah

References

  1. Chang M., Cunha B. 2004; Streptococcus agalactiae (Group B Streptococcus) infective endocarditis complicated by myocardial abscess and heart block. Infect Dis Clin Pract 12:107–109 [View Article]
    [Google Scholar]
  2. Grabe M., Bishop M.C., Bjerklund-Johansen T.E., Botto H., Cek M., Lobel B., Naber K.G., Palous J., Tenke P. 2008 The Management of Male Urinary and Genital Tract Infections European Association of Urology;
    [Google Scholar]
  3. Kang D.H., Kim Y.J., Kim S.H., Sun B.J., Kim D.H., Yun S.C., Song J.M., Choo S.J., Chung C.H., other authors. 2012; Early surgery versus conventional treatment for infective endocarditis. N Engl J Med 366:2466–2473 [View Article][PubMed]
    [Google Scholar]
  4. Prendergast B.D., Tornos P. 2010; Surgery for infective endocarditis: who and when?. Circulation 121:1141–1152 [View Article][PubMed]
    [Google Scholar]
  5. Sambola A., Miro J.M., Tornos M.P., Almirante B., Moreno-Torrico A., Gurgui M., Martinez E., Del Rio A., Azqueta M., other authors. 2002; Streptococcus agalactiae infective endocarditis: analysis of 30 cases and review of the literature, 1962–1998. Clin Infect Dis 34:1576–1584 [View Article][PubMed]
    [Google Scholar]
  6. Scully B.E., Neu H.C., Spriggs D. 1987; Streptococcus agalactiae (group B) endocarditis – a description of twelve cases and review of the literature. Infection 15:169–176 [View Article][PubMed]
    [Google Scholar]
  7. Takahashi H., Arif R., Kallenbach K., Tochtermann U., Karck M., Ruhparwar A. 2013; Surgical treatment of aortic valve endocarditis with left ventricular-aortic discontinuity. Ann Thorac Surg 96:72–76 [View Article][PubMed]
    [Google Scholar]
/content/journal/jmmcr/10.1099/jmmcr.0.000047
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.000047
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error