Unusual cause of severe diabetic ketoacidosis precipitated by Streptococcus bovis/equinus (SBSEC) bacteremia: Case report and review of literature

Idrees, Sana; Gupta, Sonali; Mantilla, M.L. Valcuende; Goyal, Pradeep; Hulinsky, Ilja

doi:10.1016/j.idcr.2017.12.004

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…Two cases of IE are reported, one in a patient with preexisting heart valve disease [9] and another in a patient with recent coronary artery bypass grafting [10]. Furthermore, there is one case of severe diabetic ketoacidosis caused by S.alactolyticus bacteraemia [11] and one fatal case of fulminant neonatal sepsis caused by the same pathogen [12]. In our case, the patient had a history of mitral valve prolapse, a risk factor for IE [13,14].…”

Section: Discussionmentioning

confidence: 67%

Human disease caused by <em>Streptococcus alactolyticus</em>: a case report of native valve infective endocarditis and review of the literature

Mylonas¹,

Gomatou²,

Poulakou³

et al. 2020

Monaldi Arch Chest Dis

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Streptococcus alactolyticus, a member of the Streptococcus bovis/Streptoccus equinus complex, is primarily hosted in the gastrointestinal tract of animals and rarely of humans, with only scarce reports relating to human disease. We herein present a case of subacute infective endocarditis (IE) caused by S. alactolyticus in a 64-year old male with pre-existing mitral prolapse. Despite a 10-month history of low-grade fever and weight loss, the diagnosis of IE was triggered by left quadrant abdominal pain which revealed splenic infarcts on computed tomography. A definitive diagnosis of IE was subsequently established by four consecutive blood cultures positive for S.alactolyticus plus demonstration of a vegetation on the mitral valve by trans-esophageal ultrasound. Further workup revealed multiple embolic phenomena including brain and spine. A dental abscess was identified as the most probable origin of the bacteraemia, while colonoscopy revealed no evidence of cancer. The patient recovered uneventfully with antibiotic treatment and underwent successful cardiac surgery post-discharge. Although rare, IE caused by S. alactolyticus may be severe and of obscure origin; oral cavity should not be overlooked as a possible origin. Attention should be given in patients with preexisting risk factors.

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Section: Discussionmentioning

confidence: 67%

Human disease caused by <em>Streptococcus alactolyticus</em>: a case report of native valve infective endocarditis and review of the literature

Mylonas¹,

Gomatou²,

Poulakou³

et al. 2020

Monaldi Arch Chest Dis

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“…The same mechanism is frequently involved in several extra-cardiac conditions caused by SBSEC ( 3 ). S. alactolyticus has been described as a precipitator agent in a case of severe diabetic ketoacidosis and in two cases of extra-cardiac infection: a fulminant neonatal sepsis and a recent case of neonatal meningitis ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Streptococcus alactolyticus as a Rare Pathogen of Mitral Endocarditis

Vinciguerra

Santamaria

Romiti

et al. 2021

Front. Cardiovasc. Med.

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Streptococcus bovis/Streptococcus equinus complex (SBSEC) is a group of non-enterococcal group D Streptococci that colonizes both humans and animals. Due to gastrointestinal disease, they can switch in opportunistic pathogens passing through intestinal mucosal barrier and may cause bacteremia and distant organs damage. Despite infective endocarditis (IE), extra-cardiac manifestations of organs damage include osteoarticular infections, meningitis, and biliary infections among others; moreover, the association with colonic pathological lesions has been largely described. Streptococcus alactolyticus as a species included in SBSEC may share pathophysiological similarities, although it represents an extremely rare cause of distant organ infections, being reported in literature as causative agent of IE in only two other cases. We describe a case of 69-year-old male admitted to our institution due to mild–moderate dyspnea and fever, affected by cervico-brachialgia for 3 weeks. Streptococcus alactolyticus was identified as causative agent of IE on the mitral valve, causing severe regurgitation.

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“…A 65-year-old woman with a history of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy was diagnosed as S. alactolyticus infective endocarditis which was complicated by septic emboli and mycotic left middle cerebral artery aneurysm [4]. A 35-year-old type 1 diabetic woman who presented with severe diabetic ketoacidosis, precipitated by S. alactolyticus bacteremia, was successfully treated [5]. Toepfner et al [2] described neonatal fulminant sepsis caused by S. alactolyticus; a fullterm infant that did not have any prenatal problem showed respiratory failure immediately after birth.…”

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confidence: 99%

The First Case Report of Neonatal Bacterial Meningitis Caused by Streptococcus alactolyticus

et al. 2020

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Streptococcus alactolyticus is grouped in S. bovis/S. equinus complex (SBSEC). SBSEC is found in the intestinal flora of humans and animals [1]. Certain bacteria include in SBSEC have caused human infection such as bacteremia or meningitis, but S. alactolyticus was identified rarely as pathogen in a few case. Especially, only one case was reported in neonatal sepsis. A case of fatal neonatal sepsis without meningitis due to S. alactolyticus has been reported, but the pathogen was identified in gastric fluid and samples from ear, trachea, and nasopharynx, not in blood and cerebrospinal fluid (CSF) [2]. Until now, there was no case report that was culture-proven S. alactolyticus as pathogen of neonatal bacterial meningitis. This is the first case presenting neonatal bacterial meningitis and sepsis caused by S. alactolyticus and treated successfully. A 28-day-old baby girl presented to our hospital with 2 day-fever history. She was born at 36 weeks and 2 days of gestational age, weighing 2,800 g by cesarean section. There were no prenatal and perinatal problems. After birth, she was healthy, fed well and had been cared-for at home. She got hepatitis B vaccination at birth. Examinations on other hospital revealed a fever, heart rate, and respiration rate of 38.7°C, 168 beats/min, and 44/min, respectively. There were Letter to the editor

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Unusual cause of severe diabetic ketoacidosis precipitated by Streptococcus bovis/equinus (SBSEC) bacteremia: Case report and review of literature

Cited by 5 publications

References 16 publications

Human disease caused by <em>Streptococcus alactolyticus</em>: a case report of native valve infective endocarditis and review of the literature

Human disease caused by <em>Streptococcus alactolyticus</em>: a case report of native valve infective endocarditis and review of the literature

Case Report: Streptococcus alactolyticus as a Rare Pathogen of Mitral Endocarditis

The First Case Report of Neonatal Bacterial Meningitis Caused by Streptococcus alactolyticus

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