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Review
. 2008 Nov 10:8:154.
doi: 10.1186/1471-2334-8-154.

Streptococcus intermedius causing infective endocarditis and abscesses: a report of three cases and review of the literature

MaryAnn P Tran  1 , Molly Caldwell-McMillan, Walid Khalife, Vincent B Young
Affiliations
Review

Streptococcus intermedius causing infective endocarditis and abscesses: a report of three cases and review of the literature

MaryAnn P Tran et al. BMC Infect Dis. .

Abstract

Background: Streptococcus intermedius is a member of the Streptococcus anginosus group. Clinical disease with S. intermedius is characterized by abscess formation and rarely endocarditis. Identification of Streptococcus intermedius is difficult, leading to the development of molecular methods to more accurately identify and characterize this organism.

Case presentation: Over a period of 6 months we encountered three cases of invasive Streptococcus intermedius infection presenting as hepatic abscesses, brain abscess, and endocarditis. We confirmed our microbiologic diagnosis through 16S sequencing and found a common virulence gene in each case.

Conclusion: Our report illustrates three different clinical manifestations due to Streptococcus intermedius infection that can be encountered in healthy individuals in a community hospital setting. To our knowledge, this is the first case of Streptococcus intermedius endocarditis confirmed by 16S sequencing analysis. The use of molecular methods may allow a better understanding of the epidemiology and pathogenesis of this organism.

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Figures

Figure 1
Figure 1
Transesophageal echocardiogram image of the mitral valve showing a highly mobile linear echodensity on the ventricular side of the mitral leaflet.
Figure 2
Figure 2
CT scan of the abdomen with contrast of Case 2 showing a large, loculated liver abscess measuring 10 cm.
Figure 3
Figure 3
Gram stain of brain tissue from Case 3 showing gram positive cocci in chains.
See this image and copyright information in PMC

References

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