Document Detail


Clinical profile of Streptococcus agalactiae native valve endocarditis.
MedLine Citation:
PMID:  14661005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Streptococcus agalactiae is an unusual pathogen in adults who are not pregnant. S agalactiae endocarditis is a poorly defined entity because it is uncommon; in contrast to other streptococcal endocarditis, it bears a high mortality rate. The aim of this study was to define its clinical, prognostic, and therapeutic profile on the basis of a series of 9 consecutive patients. METHODS: We conducted a prospective and multicenter study of patients with infectious endocarditis in which 310 episodes were included. RESULTS: S agalactiae grew in 9 patients (3%) who had no valve prosthesis. All patients except 1 had underlying diseases, and all patients had serious complications; the most common complications were major emboli, heart failure, and shock. The valve affected was the mitral valve in 4 patients, the aortic valve in 2 patients, both the mitral and aortic valves in 2 patients, and the tricuspid valve in 1 patient. All episodes were on native valves. Vegetations tended to be large (maximal diameter >10 mm in all patients), very mobile, and pedunculated. An abscess was found in 2 patients, and a perforation of the valve developed in 3 patients. Five patients died (mortality rate, 56%), 3 of whom had received antibiotic therapy alone. The 4 patients who survived underwent combined medical-surgical therapy. CONCLUSION: S agalactiae native valve endocarditis is very aggressive, and early surgery should be considered to prevent the destruction of valves and development of serious complications.
Authors:
María Jesús Rollán; José Alberto San Román; Isidre Vilacosta; Cristina Sarriá; Javier López; María Acuña; José Luis Bratos
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  American heart journal     Volume:  146     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-08     Completed Date:  2004-01-13     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1095-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Hospital Universitario del Río Hortega, Valladolid, Spain. asanroman@secardiologia.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve / microbiology,  ultrasonography
Endocarditis, Bacterial / complications,  microbiology*,  ultrasonography
Female
Humans
Male
Middle Aged
Mitral Valve / microbiology,  ultrasonography
Prospective Studies
Streptococcal Infections / microbiology*,  ultrasonography
Streptococcus agalactiae*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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