Streptococcus anginosus endocarditis and multiple liver abscesses in a splenectomised patient

BMJ Case Rep. 2018 Apr 27:2018:bcr2018224266. doi: 10.1136/bcr-2018-224266.

Abstract

An unusual case of infective endocarditis and concurrent multiple liver abscesses both caused by Streptococcus anginosus in a splenectomised patient is reported. The microorganism is a very rare cause of endocarditis and its presentation with multiple liver abscesses is highly unusual. It was initially misdiagnosed as Streptococcus sanguinis and issues relating to the different clinical presentations of S. anginosus including the rare cases of endocarditis, the role of the patient's splenectomy and problems that may contribute to its potential laboratory misidentifications are discussed.

Keywords: Infective endocarditis; Liver abscess; Streptococcus anginosus.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Infective Agents / administration & dosage
  • Diagnostic Errors
  • Echocardiography, Transesophageal
  • Endocarditis, Bacterial / complications
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / microbiology*
  • Humans
  • Image-Guided Biopsy
  • Liver Abscess / complications
  • Liver Abscess / microbiology*
  • Male
  • Metronidazole / administration & dosage
  • RNA, Ribosomal, 16S
  • Sequence Analysis, DNA
  • Splenectomy* / adverse effects
  • Streptococcal Infections / complications
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology*
  • Streptococcus anginosus / isolation & purification*

Substances

  • Anti-Infective Agents
  • RNA, Ribosomal, 16S
  • Metronidazole