Unusual Case Report of Infective Endocarditis Due to Streptococcus Agalactiae in Lebanon

Laurentia Fidella Averina  Setia Santoso; Ribal Hassane Al  Mokdad; Mustafa  Saleh; Ahmad Mohamad  Ezzedine; Mohammed Shawki  Dabbous

doi:10.18502/jthc.v20i3.20116

Laurentia Fidella Averina Setia Santoso Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
Ribal Hassane Al Mokdad Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Mustafa Saleh Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Ahmad Mohamad Ezzedine Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Mohammed Shawki Dabbous Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.

DOI: https://doi.org/10.18502/jthc.v20i3.20116

Keywords: This case represents an unusual instance of right-sided IE due to S agalactiae in Lebanon, for which definitive treatment guidance remains limited.

Abstract

Background: Right-sided infective endocarditis (IE) is uncommon. Furthermore, Streptococcus agalactiae (S agalactiae) rarely causes IE, with only 2% to 9% of bacteremia cases manifesting as endocarditis.

Case Presentation: A 30-year-old Lebanese woman presented to the emergency department with high-grade fever and chills. Blood tests were obtained, urinalysis showed leukocytes, and treatment for urinary tract infection was initiated. The patient was hospitalized 3 days later and transferred to the ICU. Echocardiography revealed severe right-sided cardiomegaly, flail tricuspid leaflets with ruptured chordae, and a large coaptation defect. She was diagnosed with right-sided IE due to S agalactiae and underwent tricuspid valve replacement. Unfortunately, the patient died from acute decompensated heart failure.

Conclusion: This case represents an unusual instance of right-sided IE due to S agalactiae in Lebanon, for which definitive treatment guidance remains limited.