title: Streptococcus constellatus causing myocardial abscess complicated by cerebritis.
abstract: Streptococcus constellatus infection is a rare cause of myocardial abscess. The complication of cerebritis is also rare. We report a case of S. constellatus bacteremia in a 21-year-old woman who developed fever and watery diarrhea 7 days prior to admission. Computed tomography of the brain showed severe effacement of the cerebral sulci, narrowing of the ventricular system, and severe brain swelling. Echocardiography showed a cystic lesion of about 2 cm(2) over the left atrium. Mannitol and dexamethasone were administered. Hyperventilation was performed. Intravenous penicillin G and ceftazidime were administered but without response. The increased intracranial pressure persisted despite medical treatment. She died 3 days after admission. Culture of cerebrospinal fluid grew S. constellatus and 3 sets of blood cultures grew S. constellatus. This case emphasizes the potential pathogenic role of S. constellatus in myocardial abscess.
authors.affiliation: Section of Infectious Disease, Armed Forces Tsoying Hospital, Kaohsiung, Taiwan, ROC. wenchengtsai001@yahoo.tw
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Tsai
authors.forename: Liang-Kai
authors.initials: LK
authors.lastname: Chang
authors.forename: Tzu-Chiang
authors.initials: TC
authors.lastname: Lin
mesh_terms: D000038:Abscess / Q000150:complications / Q000382:microbiology*; D000328:Adult; D016470:Bacteremia / Q000150:complications / Q000382:microbiology*; D009202:Cardiomyopathies / Q000150:complications / Q000382:microbiology*; D004660:Encephalitis / Q000150:complications* / Q000382:microbiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D013290:Streptococcal Infections / Q000150:complications / Q000382:microbiology; D034365:Streptococcus constellatus