Streptococcus agalactiae infective endocarditis with large vegetation in a patient with underlying protein S deficiency

H-L Cheng; W-C Lin; P-Y Shih; C-H Huang; Y-C Hsu; J-C Yie; S-Y Chen; C-P Lin

doi:10.1007/s15010-012-0334-6

Streptococcus agalactiae infective endocarditis with large vegetation in a patient with underlying protein S deficiency

Infection. 2013 Feb;41(1):247-50. doi: 10.1007/s15010-012-0334-6. Epub 2012 Sep 22.

Authors

H-L Cheng¹, W-C Lin, P-Y Shih, C-H Huang, Y-C Hsu, J-C Yie, S-Y Chen, C-P Lin

Affiliation

¹ Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.

PMID: 23001489
DOI: 10.1007/s15010-012-0334-6

Abstract

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.

Publication types

Case Reports

MeSH terms

Aged, 80 and over
Echocardiography, Transesophageal
Endocarditis, Bacterial / complications*
Endocarditis, Bacterial / diagnosis
Endocarditis, Bacterial / drug therapy
Female
Humans
Mitral Valve Insufficiency / complications*
Mitral Valve Insufficiency / diagnosis
Mitral Valve Insufficiency / surgery
Protein S Deficiency / complications*
Streptococcal Infections / complications*
Streptococcal Infections / diagnosis
Streptococcal Infections / drug therapy
Treatment Outcome