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Case Reports
. 2023 May 3:10:1117474.
doi: 10.3389/fmed.2023.1117474. eCollection 2023.

Abiotrophia defectiva causing infective endocarditis with brain infarction and subarachnoid hemorrhage: a case report

Miaojuan Yang #  1   2   3 , Yanxia Lin #  4 , Xin Peng  5 , Jingsong Wu  6 , Bo Hu  1   2   3 , Yitao He  1   2   3 , Jian Lu  4
Affiliations
Case Reports

Abiotrophia defectiva causing infective endocarditis with brain infarction and subarachnoid hemorrhage: a case report

Miaojuan Yang et al. Front Med (Lausanne). .

Abstract

Introduction: A rare pathogen of Infective Endocarditis (IE), the Abiotrophia defectiva, has been known to trigger life-threatening complications. The case discussed here is of a teenager with brain infarction and subarachnoid hemorrhage caused by IE due to A. defectiva.

Case report: A 15-year-old girl with movement disorders involving the left limbs and intermittent fevers was admitted to the hospital. A head CT scan revealed cerebral infarction in the right basal ganglia and subarachnoid hemorrhage. Moreover, vegetation on the mitral valve were confirmed by echocardiography. The blood cultures were found to be positive for Gram-positive streptococcus and identified by Vitek mass spectrometry as A. defectiva. She was prescribed vancomycin antibacterial therapy and underwent a surgical mitral valve replacement.

Conclusion: This case is suggestive of the fact that A. defectiva is a rare but crucial pathogen of IE-associated stroke. Obtaining early blood cultures and using microbial mass spectrometry could help achieve an accurate diagnosis. Moreover, reasonable anti-infective medications and surgical interventions need to be combined to avoid and/or manage severe complications.

Keywords: Abiotrophia defectiva; brain infarction; infective endocarditis; microbial mass spectrometry; subarachnoid hemorrhage.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Head CT of the patient (A) the red arrow indicates infarction of the right basal ganglia. (B) The red arrow indicates subarachnoid hemorrhage.
Figure 2
Figure 2
Transthoracic echocardiography examination of the heart in the patient. (A) THE red arrow indicates the vegetation (2.3 × 1.3 cm) on the mitral valve. (B) The red arrow indicates another position of the vegetation (2.3 × 0.7 cm) on the mitral valve. LA: left atrium; LV: left ventricle.
Figure 3
Figure 3
Overview of Abiotrophia defectiva of growth morphology (A) Colony growth of A. defectiva on blood agar. (B) Smear showing gram-positive cocci in chains.
See this image and copyright information in PMC

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