Open AccessA rare case of right‐sided infective endocarditis caused by group B Streptococcus complicated with septic knee arthritis and subcutaneous abscess in the lower extremity
Author(s) -
Takeda Shinsuke,
Tanaka Yoshihiro,
Takeichi Yosuke,
Hirata Hitoshi,
Tabuchi Akihiko
Publication year - 2019
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.456
Subject(s) - medicine , septic arthritis , infective endocarditis , endocarditis , abscess , surgery , diabetes mellitus , tricuspid valve , complication , arthritis , endocrinology
Background Several reports have assessed group B Streptococcus ( GBS ) infections in non‐pregnant cohorts, especially in immunocompromised hosts and patients with severe disease, including diabetes mellitus. Case presentation We report a rare case of large GBS ‐ associated tricuspid valve infective endocarditis ( IE ) complicated with septic knee arthritis and s.c. abscess formation in the lower extremity of a non‐i.v. drug user. After confirming the absence of vegetation on transthoracic echocardiography ( TTE ) at admission, the lower extremity was irrigated, and antibiotic therapy was initiated. One week later, the causes of persistent fever were reinvestigated. The TTE detected a large mass around the tricuspid valve. The cultured GBS was penicillin sensitive. The vegetation completely disappeared without surgery within 4 weeks. Conclusion When patients with untreated diabetes mellitus have persistent fever and s.c. abscess or septic arthritis, IE is a possible differential diagnosis. Repetitive evaluation by TTE is warranted to avoid this fatal complication.