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Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, Caselli S, Doenst T, Ederhy S, Erba PA, Foldager D, Fosbøl EL, Kovac J, Mestres CA, Miller OI, Miro JM, Pazdernik M, Pizzi MN, Quintana E, Rasmussen TB, Ristić AD, Rodés-Cabau J, Sionis A, Zühlke LJ, Borger MA. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023; 44:3948-4042. [PMID: 37622656 DOI: 10.1093/eurheartj/ehad193] [Citation(s) in RCA: 268] [Impact Index Per Article: 268.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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Dean KR, Koirala A, Samarasekara H. A case report of disseminated Streptococcus pneumoniae infection complicated by infective endocarditis, septic arthritis and epidural abscess in an immunocompetent patient. Access Microbiol 2023; 5:acmi000611.v3. [PMID: 37601436 PMCID: PMC10436013 DOI: 10.1099/acmi.0.000611.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/28/2023] [Indexed: 08/22/2023] Open
Abstract
Streptococcus pneumoniae is a highly virulent, vaccine-preventable pathogen which can cause disease on a spectrum from benign to fatal. Apart from pneumonia, it commonly causes septicaemia and meningitis. This case report describes an unusual range of complications in a 53-year-old Caucasian female presenting to a regional hospital, without any risk known factors for severe disease (such as extremes of age, immunodeficiency or co-morbidities). Progressing from an episode of otitis media, her condition rapidly progressed to mastoid sinusitis, septic arthritis, infective endocarditis, epidural abscesses and multiple subcutaneous abscesses. Following quick identification of S. pneumoniae from a positive blood culture, the patient was treated with high-dose benzylpenicillin and ceftriaxone and aggressive source control by surgery, enabling a good clinical recovery.
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Affiliation(s)
- Kimberley Rose Dean
- Resident Medical Officer, Orange Health Service of Western NSW Local Health District, 1530 Forest Road, Orange, NSW 2800, Australia
| | - Archana Koirala
- Staff Specialist in Immunology and Paediatrics, New South Wales Immunisation Specialist Service (NSWISS) Team, Nepean Blue Mountains Local Health District, Derby St., Kingswood, NSW 2747, Australia
| | - Harsha Samarasekara
- Supervising Pathologist, Department of Microbiology, Pathology West-Orange, Orange Health Service, 1530 Forest Road, Orange, NSW 2800, Australia
- Staff Specialist in Department of Pathology, Nepean Hospital of Nepean Blue Mountains Local Health District, Derby St, Kingswood NSW 2747, Australia
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Erdem S, Patel D, Patel SV, Patel S, Patel S, Kanwar A. Streptococcus pneumoniae Serotype 23B Causing Asymptomatic Sinusitis Complicated by Endocarditis and Meningitis: Sequela of a Non-vaccine Serotype. Cureus 2023; 15:e41892. [PMID: 37581129 PMCID: PMC10423637 DOI: 10.7759/cureus.41892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/16/2023] Open
Abstract
We describe a rare case of a Streptococcus pneumoniae (S. pneumoniae) infection causing mitral valve endocarditis and bacterial meningitis in a previously healthy young adult male in his 20s who presented with altered mentation. Though our patient did not endorse any respiratory issues, we suspected the paranasal sinuses to have been the cryptic primary source of disseminated infection into the respiratory system and meninges due to incidental mucosal thickening being found on imaging. Blood and cerebrospinal fluid analyses and cultures revealed the proliferation of S. pneumoniae serotype 23B, despite our patient having previously received appropriate pneumococcal vaccinations in his childhood without delinquency. Ultimately, surgical replacement of the mitral valve, as well as a course of ceftriaxone, was indicated for this patient, in which full resolution of symptoms was achieved upon discharge.
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Affiliation(s)
- Saliha Erdem
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Dhruvil Patel
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Suraj V Patel
- Internal Medicine, Ross University School of Medicine, Miramar, USA
| | - Shlok Patel
- Medical School, University of Michigan, Ann Arbor, USA
| | - Shivam Patel
- Medical School, University of South Florida, Tampa, USA
| | - Amrit Kanwar
- Cardiology, Detroit Medical Center, Detroit, USA
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Kenig A, Oster Y, Cohen-Poradosu R, Reisenberg K, Wieder-Finesod A, Hershman-Sarafov M, Oren I, Weber G, Dagan R, Regev-Yochay G, Strahilevitz J. Characteristics of endovascular pneumococcal infections; a decade of nationwide surveillance study. Eur J Clin Microbiol Infect Dis 2022; 41:1365-1370. [PMID: 36175812 DOI: 10.1007/s10096-022-04500-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022]
Abstract
In order to characterize pneumococcal endovascular infection in the post-vaccination era, a retrospective nationwide study based on the Israeli Adult IPD database was conducted. Between 2010 and 2019, 0.6% (23 cases) of IPD cases were of endovascular type, occurring mainly in males (72.3%) with underlying medical conditions (78.2%). Additional pneumococcal source (10 patients) and concomitant infections were not uncommon. Penicillin and ceftriaxone susceptibility rates were 65.2% and 91.3%, respectively; 60.9% of the isolates were not covered by the pneumococcal conjugate vaccine. 21.7% of patients died during hospitalization. In conclusion, pneumococcal endovascular infections still carry significant morbidity and mortality.
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Affiliation(s)
- Ariel Kenig
- Department of Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yonatan Oster
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Ein Kerem, 91120, Jerusalem, Israel
| | | | - Klaris Reisenberg
- Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Anat Wieder-Finesod
- Infectious Disease Unit, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Ilana Oren
- Infectious Disease Unit, Rambam Medical Center, Haifa, Israel
| | - Gabriel Weber
- Infectious Disease Unit, Carmel Medical Center, Haifa, Israel.,Faculty of Medicine Technion, Israel Institute of Technology, Haifa, Israel
| | - Ron Dagan
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gili Regev-Yochay
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel
| | - Jacob Strahilevitz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. .,Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Ein Kerem, 91120, Jerusalem, Israel.
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Infective endocarditis caused by Streptococcus pneumoniae from sinusitis: A case report. J Cardiol Cases 2021; 25:279-281. [DOI: 10.1016/j.jccase.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 09/10/2021] [Accepted: 11/08/2021] [Indexed: 11/21/2022] Open
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6
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Machiavello Roman F. A case of pneumococcal tricuspid endocarditis: An oslerian diagnosis. IDCases 2021; 24:e01155. [PMID: 34026542 PMCID: PMC8134731 DOI: 10.1016/j.idcr.2021.e01155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 11/25/2022] Open
Abstract
Pneumococcal endocarditis is a rare manifestation of S. pneumoniae infection. It affects mainly middle-aged men without traditional risk factors for IE. Isolates have high sensitivity to penicillin, but cardiac complications are common.
Streptococcal infections present in a variety of clinical syndromes. Invasive disease, such as infective endocarditis, was common in the pre-antibiotic era but is now seldom encountered. The author reports the case of an elderly man with pneumococcal tricuspid endocarditis presenting with fever and syncope, and reviews current literature regarding the epidemiology, clinical features and treatment of this condition.
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Nakamura S, Hanayama N, Matushita H, Sakaki K. Detachment of a prosthetic valve due to infective endocarditis caused by Streptococcus pneumoniae. Clin Case Rep 2020; 8:1357-1360. [PMID: 32884753 PMCID: PMC7455410 DOI: 10.1002/ccr3.2749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/24/2019] [Accepted: 01/21/2020] [Indexed: 12/04/2022] Open
Abstract
The incidence of infective endocarditis (IE) due to S pneumoniae has decreased, thanks to antibiotics. However, when it does occur, it can be lethal. The present case provides a reminder of the potential lethality of this postoperative infection.
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Affiliation(s)
- Saori Nakamura
- Department of Cardiothoracic SurgeryKanto Rosai HospitalKanagawaJapan
- Department of CardiologyTokyo Metropolitan Tama Medical CenterTokyoJapan
| | - Naoji Hanayama
- Department of Cardiothoracic SurgeryKanto Rosai HospitalKanagawaJapan
| | - Hiroshi Matushita
- Department of Cardiothoracic SurgeryKanto Rosai HospitalKanagawaJapan
| | - Kenjiro Sakaki
- Department of Cardiothoracic SurgeryKanto Rosai HospitalKanagawaJapan
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