title: Pneumococcal endocarditis causing valve destruction in the absence of vegetations on transesophageal echocardiography: a series of 3 consecutive cases.
abstract: Streptococcus pneumoniae endocarditis is uncommon. It has a predilection for the aortic valve and is associated with high mortality. We present 3 consecutive cases of pneumococcal endocarditis, each preceded by a different extracardiac infection but all causing destructive aortic valve lesions associated with severe regurgitation, in the absence of vegetations on transesophageal echocardiography. This case series illustrates the aggressive nature of pneumococcal endocarditis and the need for early diagnosis. Echocardiography should be considered in all individuals with persistent extracardiac pneumococcal infections.
authors.affiliation: Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Tsang
authors.forename: Suresh
authors.initials: S
authors.lastname: Perera
authors.forename: Eva
authors.initials: E
authors.lastname: Lonn
authors.forename: Hisham
authors.initials: H
authors.lastname: Dokainish
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000382:microbiology*; D016887:Cardiopulmonary Resuscitation; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications*; D017809:Fatal Outcome; D006323:Heart Arrest; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000150:complications*; D012128:Respiratory Distress Syndrome / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D016896:Treatment Outcome