A Rare Case of Group A Streptococcal Endocarditis with Absence of Valvular Vegetation

作者：Branch Joel^*; Suganami Yu; Kitagawa Izumi; Stein Gerald H; Tanaka Eri

来源：Internal Medicine, 2010, 49(15): 1657-1661.

DOI：10.2169/internalmedicine.49.3711

• Streptococcal
• endocarditis
• anticoagulation
• glomerulonephritis
• embolic

Group A streptococcal endocarditis has been described in intravenous drug misusers and as a post-varicella infection in children.
We report a 64-year-old man with no prior risk factors who presented with a persistent fever, malaise, polyuria and cola-colored urine. On examination peripheral stigmata of endocarditis without a cardiac murmur and asymptomatic pharyngeal exudates were found. Blood and urine analysis revealed renal failure from suspected glomerulonephritis. Blood cultures revealed fully sensitive Group A streptococci. Transthoracic and transesophageal echocardiographies revealed no vegetation. The Modified Duke's Criteria aided in the diagnosis of definite infective endocarditis, despite the absence of valvular vegetation.

• 出版日期2010