Infective endocarditis caused by Streptococcus agalactiae in a native aortic valve, complicated by meningitis and cerebral embolism

Abstract

We present a case of infective endocarditis associated with community-acquired Streptococcus agalactiae in an immune competent patient. The endocarditis affected the native aortic valve with perforation of the coronary cusp and was complicated by a cerebral embolism. The use of intravenous ampicillin produced a satisfactory clinical and echocardiographic recovery despite not receiving a valve replacement. In addition to reporting an extremely rare case, this paper confirms that the opportune identification of endocarditis caused by S. agalactiae and the selection of appropriate antibiotics can prevent the necessity of cardiac surgery, usually required in such cases. © 2009 The Japanese Society of Internal Medicine.