Streptococcus agalactiae infective endocarditis with large vegetation in a patient with underlying protein S deficiency
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- Cheng, HL., Lin, WC., Shih, PY. et al. Infection (2013) 41: 247. doi:10.1007/s15010-012-0334-6
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We present a case of a patient with underlying protein S deficiency who suffered from infective endocarditis with a large anterior mitral leaflet (AML) mass of approximately 4.5 cm in length. Intraoperative transesophageal echocardiography (TEE) revealed the mass at the AML base and a rupture of the posterior mitral leaflet chordae tendinae. The vegetation’s large size may have been caused by one or more of three factors: location, underlying disease, and the microorganism causing infection. Patients with protein S deficiency are prone to thromboembolic events during cardiac surgery. Infective endocarditis caused by Streptococcus agalactiae usually has a poor prognosis, and, thus, early surgery is recommended.