Title : Native aortic valve endocarditis secondary to streptococcus gordonii: A rare presentation
Abstract:
Streptococcus Gordonii (SG) is an alpha hemolytic gram-positive streptococcus bacterium most commonly present in the oral cavity and gastrointestinal tract [1]. Despite an increase in the incidence of Infective Endocarditis, SG cases reported on a native aortic valve are relatively uncommon. Previous cases of SG have been associated with spondylodiskitis, intraabdominal infection, and oral procedures [3]. We present a case of a 79-year-old male with a native aortic valve SG endocarditis that was admitted for AKI, diarrhea, and dehydration, found have SG bacteremia with endocarditis, 1.7cm vegetation on native aortic valve and subsequent multiple septic emboli on brain MRI. The patient was successfully treated with IV antibiotics and required aortic valve replacement at following hospitalization. The most likely source of the bacteremia was a trigger point injection to the lumbar spine which was consist with MRI lumbar spine findings of spinal abscess. However, other possible sources include oral procedure and colonoscopy with polypectomy within 8 weeks of the hospitalization. This case illustrates the importance of thorough history taking and consideration for echocardiogram to rule out endocarditis if SG bacteremia is present, in addition to close monitoring and outpatient follow up post diagnosis. Considering an increasing number of procedures involving the oral cavity, spine and abdominal area, and we hope that this case will bring awareness in the diagnosis of SG endocarditis.
