Herein we reported a 35-year-old man who developed endocarditis caused by Streptococcus (S) constellatus, a member of S. milleri group. Unlike other viridans streptococci, members of the S. milleri group rarely cause infective endocarditis.
A 35- year-old male patient was admitted to our clinic with complaints of tiredness, night sweating, cough and fever lasting two months. On clinical examination, vital signs except body temperature (39.5[degrees]C) were within normal limits. We detected 2/4th grade diastolic murmur along left sternal border. His blood analysis revealed hematocrit 45%, leucocytes 16500/ mm3, ESR 75 mm/h. On his transthoracic echocardiographic examination severe aortic regurgitation, mild degree aortic stenosis (peak gradient 21 mmHg) and multiple vegetations on the aortic cusps (maximum diameter 9X5 mm) were seen (Fig.1). Two blood cultures for aerobic and anaerobic pathogens were immediately taken and therapy with penicillin G-gentamycin combination was initiated.
From blood cultures evaluated with The BacT/ALERT and the BACTEC 9240 systems viridans streptococci were isolated. Despite intensive antibiotic therapy, the patient's general condition was not improved, and hence, another set of blood cultures was obtained. The isolates grew well and had pinpoint colonies of alpha-hemolysis on 5% defibrinated...
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