Streptococcus Gallolyticus endocarditis in patient with liver cirrhosis: a case report.

Journal: Journal of infection in developing countries
PMID:

Abstract

Streptococcus gallolyticus (S. gallolyticus) bacteremia is commonly associated with endocarditis and diseases of gastrointestinal tract, especially with colorectal carcinoma. On the other side, it is rarely connected to liver disease, especially alcoholic liver disease. A 44-old patient with a history of one month fever, pre-existing heart murmur and previous alcohol abuse, was treated in Clinic for Infectious and tropical diseases, Clinical Centre of Serbia (CCS), Belgrade. The diagnose of infective endocarditis (IE) of the aortic valve caused by S. gallolyticus has been established. Despite the conducted antibiotic treatment based on antibiogram, pericardial effusion with paracardial aortic abscess was diagnosed on the 9th day of treatment. Pericardiocentesis was done and 800 mL of haemorrhagic fluid was evacuated in the Clinic for Cardiology, CCS. Unfortunately, 20th day of hospitalization the patient died. Clinical autopsy confirmed endocarditis, liver cirrhosis and chronic pericarditis. Prognosis of the outcome of treatment of patient with endocarditis caused S. gallolyticus and liver cirrhosis is not optimistic. Therefore, significant attention should be given to patients with liver cirrhosis and febrile of unknown origin.

Authors

  • Aleksandra Radovanovic Spurnić
    Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia. spurnic@yahoo.com.
  • Ivana Gmizić
    Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia. gmizic.ivana@yahoo.com.
  • Ivana Milošević
    Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia. ivanamilosevc00@gmail.com.
  • Olga Petrović
    Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia. olpet@yahoo.com.
  • Danilo Obradović
    Institute for Pathology, School of Medicine University of Belgrade, Belgrade, Serbia. drdanilobradovic@gmail.com.
  • Arsen Ristić
    Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia. arrist@yahoo.com.
  • Olja Stevanović
    Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia. stevanovicolja74@gmail.com.