A complication of meningitis and infective endocarditis due to Streptococcus pyogenes

BMJ Case Rep. 2017 Jul 26:2017:bcr2017220847. doi: 10.1136/bcr-2017-220847.

Abstract

We described a rare case of meningitis and infective endocarditis (IE) due to Streptococcus pyogenes. An 80-year-old woman was admitted to our hospital with unconsciousness. Glasgow Coma Scale was E1V3M5. We diagnosed her with acute meningitis due to S. pyogenes and started treatment using ceftriaxone. In spite of the improvement of her unconscious state, she developed a new-onset systolic murmur on day 13, and echocardiography revealed severe mitral valve regurgitation with vegetation. Therefore, we also diagnosed her with IE and continued the antibiotics for 6 weeks after we confirmed the negative blood cultures. The patient was finally transferred to another hospital for rehabilitation 57 days after admission. Considering that the number of S. pyogenes infections has been reported to increase in Japan and worldwide, we need to be more careful about the rare complication of meningitis and IE due to S. pyogenes.

Keywords: Infectious Diseases; adult intensive care; meningitis; stroke; valvar diseases.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Ceftriaxone / therapeutic use
  • Endocarditis / microbiology*
  • Female
  • Humans
  • Meningitis / drug therapy
  • Meningitis / microbiology*
  • Streptococcal Infections / complications*
  • Streptococcal Infections / drug therapy
  • Streptococcus pyogenes / isolation & purification*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone