Tricuspid Valve Endocarditis With Group B Streptococcus After an Elective Abortion: The Need for New Data

Abstract

Streptococcus agalactiae, commonly known as Group B streptococcus (GBS), was originally discovered as a cause of bovine mastitis. GBS colonizes the genital tract of up to 40% of women and has become a major pathogen in neonatal meningitis. GBS endocarditis is thought to be an uncommon manifestation of this infection and carries a higher mortality compared to other streptococcal pathogens. Studies have shown that endocarditis after abortion has an incidence of about one per million. However, this figure was published prior to routine use of echocardiography for diagnosis. The American Heart Association has recently declared transesophageal echocardiography the gold standard for endocarditis diagnosis. This case report illustrates that, given the potentially devastating consequences of endocarditis, there is a need for updated studies to adequately assess the true incidence of this infection. Pending the outcome of these studies, routine GBS screening and prophylactic antibiotics prior to abortion should be recommended.

Postpartum culture negative endocarditis: a case report and review of the current guidelines

“…The lack of an identifiable causative pathogen is often associated with either prior use of antimicrobial agent(s), inadequate microbiological techniques or presence of fastidious organism. Tricuspid valve endocarditis in low risk patients such as ours is unusual but similar reports following abortion or during pregnancy have been documented in the literature 5–9. Diagnosis of postpartum IE is typically delayed.…”

Surgical Complications: Prevention and Management

“…Postabortal endocarditis is rare, difficult to diagnose, and often resistant to aggressive broad-spectrum antibiotic therapy [140]. Up to 75% of patients who develop postsurgical endocarditis have preexisting abnormalities of the heart [141] that are often asymptomatic.…”

Infective endocarditis in pregnant women

“…ИЭ трикуспидального клапана при беременности и после аборта чаще обусловлен стрептококками группы В [28][29][30][31]. Эти бактерии могут быть изолированы из гени-тальной зоны у 5-40% женщин и ответственны также за развитие неонатального сепсиса, хориоамнионита, эндо-метрита и бактериемии матери [25].…”