Chronic Cough Associated With Subacute Bacterial Endocarditis

Abstract

Although the literature on subacute bacterial endocarditis from both the preantibiotic and antibiotic eras mentions cough as a symptom, neither bacteremia nor endocarditis is listed in reviews on chronic cough. Herein we describe a 74-year-old man who underwent an extensive workup as an outpatient because of chronic cough of 7 months' duration. Chest roentgenography, chest and sinus computed tomography, fiberoptic bronchoscopy, gallium scan, transthoracic echocardiography, and other studies revealed no apparent cause for his nonproductive cough. Because of a persistently increased erythrocyte sedimentation rate and associated weight loss, blood cultures were obtained, all of which grew Streptococcus constellatus. A transesophageal echocardiogram revealed mitral valve vegetation. After antibiotic therapy was administered, the patient's cough completely resolved. He has experienced no coughing for more than 14 months. Bacteremia in conjunction with endocarditis should be added to the list of uncommon causes of chronic cough. The mechanism of cough is unknown.

Guidelines of the German Respiratory Society for Diagnosis and Treatment of Adults Suffering from Acute or Chronic Cough

“…" Treatment of chronic cough due to active Tb: Use additional central cough suppressants " Grade: weak ñ " Evidence: none " Chronic cough due to heart diseases: Aside from chronic left heart failure (cough generally occurs upon physical exertion or prone position), cardiac drugs including ACE inhibitors, beta-blockers (only in patients with BHR), Amiodarone (eliciting Alveolitis), AVblock II -III, endocarditis [41] and cardiac arrhythmia [42,43] can cause chronic cough. " Diffuse parenchymatous lung diseases (DPLD) -Systemic diseases with diffuse lung involvement: -DPLD: In addition to dyspnea, dry cough is the most common symptom.…”

Leitlinie der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin zur Diagnostik und Therapie von erwachsenen Patienten mit akutem und chronischem Husten

“…verschlimmern. Herzrhythmusstörungen wurden neben Hervorrufen von akutem Husten (Kapitel 5.11) auch als Ursache des chronischen Hustens beschrieben [170 -172], Endokarditis kann ebenfalls Husten verursachen [173]. An Gefäßanomalien ist ebenfalls zu denken.…”

Infective endocarditis due to a rare pathogen, Streptococcus constellatus, in a patient with gingivitis: A case report and review of the literature

“…Only 10 cases are reported in the literature [5][6][7][8][9][10][11][12][13][14]. It is reported that S. constellatus is not readily associated with the heart valves, which may explain why S. constellatus rarely causes IE [15,16].…”

“…However, 1 group of S. viridans, the S. milleri group, which includes S. constellatus, S. anginosus, and S. intermedius, rarely cause IE; among these, S. anginosus is predominant [4]. S. constellatus is a very rare pathogen of IE; there are only 10 case reports in the literature [5][6][7][8][9][10][11][12][13][14]. The clinical features of IE due to S. constellatus remain unclear.…”