title: Streptococcus agalactiae endocarditis presenting as acalculous cholecystitis in a previously well woman.
abstract: This case report describes the unusual presentation of a previously very well woman with Streptococcus agalactiae endocarditis in the emergency department. History, examination and preliminary laboratory and radiological investigations supported a diagnosis of acalculous cholecystitis, for which she was given intravenous broad spectrum antimicrobial therapy. One day following admission, the patient deteriorated and became unresponsive. Subsequent MRI of the brain revealed multiple bihemispheric cerebral emboli and a large, mobile mitral valve thrombus was visualised on her transoesophageal echocardiogram. S agalactiae was cultured from venous blood samples and her antimicrobial cover was adjusted accordingly. Despite her presumed guarded prognosis, this patient made a remarkable recovery. To our knowledge, the association of S agalactiae endocarditis with acalculous cholecystitis has not been previously described.
authors: Medicine for the Older Person,  Mater Hospital, Dublin,  Ireland.
authors: Linda
authors: L
authors: Brewer
authors: Amanda Hanora
authors: AH
authors: Lavan
authors: Laura
authors: L
authors: Cullen
authors: Joseph
authors: J
authors: Duggan
mesh_terms: D042101:Acalculous Cholecystitis / Q000175:diagnosis*; D000368:Aged; D003937:Diagnosis, Differential; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D005260:Female; D006801:Humans; D013290:Streptococcal Infections / Q000175:diagnosis*; D013292:Streptococcus agalactiae
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