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Case Reports
. 2024 Oct 6;16(10):e70934.
doi: 10.7759/cureus.70934. eCollection 2024 Oct.

A Rare Case of Acute Bacterial Native Valve Endocarditis Caused by Streptococcus thoraltensis

Shaun Abid  1 , Anton Stolear  2 , Maxim Dulgher  3 , Samdish Sethi  4 , Stuart Zarich  5
Affiliations
Case Reports

A Rare Case of Acute Bacterial Native Valve Endocarditis Caused by Streptococcus thoraltensis

Shaun Abid et al. Cureus. .

Abstract

This report presents a rare case of acute bacterial native valve endocarditis caused by Streptococcus thoraltensis in a 57-year-old male with a history of intravenous drug use. The patient presented with chest pain, productive cough, and diarrhea, with clinical evaluation revealing atrial flutter, pulmonary embolism, and a large tricuspid valve vegetation. Blood cultures confirmed Streptococcus thoraltensis, an organism rarely implicated in human infections. The patient's prior work at an animal shelter, with direct handling of rabbits, suggests a possible zoonotic transmission of the infection. Treatment with intravenous ceftriaxone resulted in partial clinical improvement, but the patient was lost to follow-up. This case highlights the importance of considering rare pathogens in endocarditis, particularly in patients with exposure to animals or intravenous drug use. It underscores the need for thorough patient history in guiding diagnosis and treatment. It adds to the limited literature on Streptococcus thoraltensis as a human pathogen, emphasizing the need for increased awareness and documentation.

Keywords: cardiology research; drug use associated infective endocarditis; emerging pathogen; infective endocarditis; streptococcus thoraltensis; tricuspid valve endocarditis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Echocardiogram showing large tricuspid valve vegetation in a patient with Streptococcus thoraltensis endocarditis.
This figure contains two panels. Panel 1 shows the echocardiogram with the tricuspid valve vegetation visible when the valve is closed. Panel 2 shows the vegetation with the valve open, highlighting the dynamic nature of the vegetation on the tricuspid valve.
Figure 2
Figure 2. Histological image of gram-positive cocci seen in chains (H&E staining).
This figure shows a histological section stained with hematoxylin and eosin (H&E), highlighting gram-positive cocci arranged in chains, characteristic of Streptococcus species.
Figure 3
Figure 3. Echocardiogram demonstrating partial resolution of tricuspid valve vegetation after eight days of antibiotic therapy.
See this image and copyright information in PMC

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