Case of Invasive Streptococcus Dysgalactiae Infection Presenting as Infective Endocarditis with Multiple Brain Embolisms

Abstract

A 65-year-old Japanese man complaining of general malaise and presenting with high fever was admitted to our hospital. He had untreated diabetes and hepatocellular carcinoma with liver cirrhosis. Overall findings of the patient indicated sepsis. Two blood cultures were positive for Streptococcus dysgalactiae, a group C or G Streptococcus. Transthoracic and transesophageal echocardiography revealed vegetations on the aortic and mitral valves. Although antimicrobial therapy with aminobenzyl penicillin was effective for controlling infection, multiple cerebral embolisms occurred in the clinical course of the disease. Primary care doctors should consider invasive Streptococcus dysgalactiae infections when treating elderly patients with underlying diseases, and Streptococcus dysgalactiae should be included in the list of microorganisms considered to cause endocarditis in such patients.