title: Clinical profile of Streptococcus agalactiae native valve endocarditis.
abstract: BACKGROUND
  Streptococcus agalactiae is an unusual pathogen in adults who are not pregnant. S agalactiae endocarditis is a poorly defined entity because it is uncommon; in contrast to other streptococcal endocarditis, it bears a high mortality rate. The aim of this study was to define its clinical, prognostic, and therapeutic profile on the basis of a series of 9 consecutive patients.
  
  
  METHODS
  We conducted a prospective and multicenter study of patients with infectious endocarditis in which 310 episodes were included.
  
  
  RESULTS
  S agalactiae grew in 9 patients (3%) who had no valve prosthesis. All patients except 1 had underlying diseases, and all patients had serious complications; the most common complications were major emboli, heart failure, and shock. The valve affected was the mitral valve in 4 patients, the aortic valve in 2 patients, both the mitral and aortic valves in 2 patients, and the tricuspid valve in 1 patient. All episodes were on native valves. Vegetations tended to be large (maximal diameter >10 mm in all patients), very mobile, and pedunculated. An abscess was found in 2 patients, and a perforation of the valve developed in 3 patients. Five patients died (mortality rate, 56%), 3 of whom had received antibiotic therapy alone. The 4 patients who survived underwent combined medical-surgical therapy.
  
  
  CONCLUSIONS
  S agalactiae native valve endocarditis is very aggressive, and early surgery should be considered to prevent the destruction of valves and development of serious complications.
authors.affiliation: Department of Cardiology, Hospital Universitario del Río Hortega, Valladolid, Spain. asanroman@secardiologia.es
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Rollán
authors.forename: José Alberto
authors.initials: JA
authors.lastname: San Román
authors.forename: Isidre
authors.initials: I
authors.lastname: Vilacosta
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarriá
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.forename: María
authors.initials: M
authors.lastname: Acuña
authors.forename: José Luis
authors.initials: JL
authors.lastname: Bratos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000382:microbiology; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology*; D013292:Streptococcus agalactiae; D014463:Ultrasonography