Severe aortic regurgitation masked as sepsis-induced ARDS in a patient with Streptococcus agalactiae endocarditis

BMJ Case Rep. 2018 Dec 4;11(1):e226681. doi: 10.1136/bcr-2018-226681.


Septic shock is the most common type of shock in the intensive care unit with an associated mortality close to 50%. Infective endocarditis (IE) is a rare cause of septic shock but carries significant morbidity and mortality. Group B Streptococcus IE (GBS-IE) is an invasive infection with an incidence of approximately 1.7%. It affects immunocompromised patients such as intravenous drug users, alcoholics, those with HIV and elderly among others. IE with severe acute valvular heart disease challenges physicians when assessing fluid status during the early resuscitation in patients with septic shock. We present a case of GBS-IE complicated by severe acute aortic regurgitation with rapidly progressive acute respiratory failure in the setting of septic shock management.

Keywords: mechanical ventilation; radiology (diagnostics); valvar diseases.

Publication types

  • Case Reports

MeSH terms

  • Alcoholism
  • Aortic Valve Insufficiency / complications
  • Aortic Valve Insufficiency / diagnosis*
  • Aortic Valve Insufficiency / diagnostic imaging
  • Diabetes Mellitus, Type 2
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Endocarditis, Bacterial / complications
  • Endocarditis, Bacterial / diagnosis*
  • Endocarditis, Bacterial / diagnostic imaging
  • Humans
  • Hypertension
  • Male
  • Middle Aged
  • Respiratory Distress Syndrome / etiology
  • Shock, Septic
  • Streptococcal Infections / complications
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / diagnostic imaging
  • Streptococcus agalactiae*