Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic aneurysms and massive splenic infarction: a case report

Abstract

BackgroundThe burden of disease caused by Streptococcus agalactiae has increased significantly among older adults in the last decades. Group B streptococcus infection can be associated with invasive disease and severe clinical syndromes, such as meningitis and endocarditis.Case presentationWe present the case of a 56-year-old man who developed multiple mycotic aneurysms of the right hepatic artery and massive splenic infarction as rare complications of Streptococcus agalactiae infective endocarditis. The patient underwent urgent right hepatic artery ligation and splenectomy. The postoperative course was complicated by an episode of hemobilia due to the rupture of a partially thrombosed mycotic aneurysm into the biliary tree. Thus, selective radiological embolization of the left hepatic artery branches was necessary.ConclusionTo our knowledge, this is the first case reported of infected aneurysms of visceral arteries caused by Group B streptococcus infection. Clinical and laboratory findings were non-specific, while imaging features with computed tomography scan and angiography were highly suggestive. In our case, early recognition, culture-specific intravenous antibiotics and urgent surgical treatment combined with interventional radiology played a decisive role in the final result.

A Rare Case of Infective Aneurysm of Mesenteric Artery Due to Infective Endocarditis: Diagnosis and Treatment

“…This illustrates that in patients with poor underlying conditions who cannot tolerate surgical management, symptomatic treatment with antibiotics alone is a therapeutic option without an indication for emergency surgery. With the continuous development of interventional methods, endovascular techniques provide an interim safeguard or therapeutic option for patients unable to undergo open surgery [11,12].…”

Enhanced Vulnerability of Diabetic Mice to Hypervirulent Streptococcus agalactiae ST-17 Infection

“…If the tilapia spleen, which is involved in the hematopoiesis process, is affected with microlesions after infection, this may cause irreversible problems such as the sudden death of the animal [39]. Additionally, the first case of GBS endocarditis in a healthy adult patient complicated by multiple mycotic aneurysms of the hepatic artery was previously described [41]. GBS infective endocarditis is an unusual cause and frequently affects patients with debilitating diseases.…”

Streptococcus agalactiae-Related Splenic Abscess in Uncontrolled Diabetes Mellitus

“…Frequently involved microorganisms in splenic abscess are Enterobacteriaceae, gram-positive cocci and anaerobes [ 4 ]. Although GBS has been increasingly identified as a cause of invasive infections in nonpregnant adults, isolated splenic abscess due to GBS infection in the absence of infective endocarditis has not been reported in literature [ 1 - 5 ]. There are many underlying conditions that can lead to an increased risk for invasive GBS disease, including diabetes, cancer, chronic kidney disease, liver cirrhosis and immunosuppression [ 2 , 3 ].…”