Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
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
McDonald J.R., et al., Enterococcal endocarditis: 107 cases from the international collaboration on endocarditis merged database, Am. J. Med., 2005, 118, 759–766
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
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
Levin R.M., et al., Penicillin-resistant Streptococcus constellatus as a cause of endocarditis, Am. J. Dis. Child., 1982, 136, 42–45
Martin L., Gustaferro C., Chronic cough associated with subacute bacterial endocarditis, Mayo Clin. Proc., 1995, 70, 662–664
Marinella M.A., Streptococcus constellatus endocarditis presenting as acute embolic stroke, Clin. Infect. Dis., 1997, 24, 1271–1272
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
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
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
Tayama E., et al., Embolic myocardial infarction and left ventricular rupture due to mitral valve endocarditis, Ann. Thorac. Cardiovasc. Surg., 2007, 13, 206–208
Senses Z., et al., A rare pathogen causing endocarditis: Streptococcus constellatus, Anadolu. Kardiyol. Derg., 2008, 8, 315–316
Wang’ondu R.W., Murray T.S., Relapse of polymicrobial endocarditis in an intravenous drug user, Yale J. Biol. Med., 2011, 84, 321–324
Concistre G., et al., Mitral and aortic valve endocarditis caused by a rare pathogen: Streptococcus constellatus, Interact. Cardiovasc. Thorac. Surg., 2012, 14, 889–890
Gossling J., Occurrence and pathogenicity of the Streptococcus milleri group, Rev. Infect. Dis., 1988, 10, 257–285
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
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
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
Kitts D., Bongard F.S., Klein S.R., Septic embolism complicating infective endocarditis, J. Vasc. Surg., 1991, 14, 480–485; discussion 485–487
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
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
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Yoshino, Y., Kimura, Y., Sakai, T. et al. Infective endocarditis due to a rare pathogen, Streptococcus constellatus, in a patient with gingivitis: A case report and review of the literature. cent.eur.j.med 8, 489–492 (2013). https://doi.org/10.2478/s11536-013-0167-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.2478/s11536-013-0167-4