title: Streptococcus gallolyticus infective endocarditis in a patient with systemic lupus erythematosus: a three-dimensional echocardiography evaluation.
abstract: A 42 year-old woman was referred to our hospital with a history of fever and poor general status for the last 30 days. She presented tachycardia and a systolic apical murmur. Laboratory tests revealed leukocytosis of 13,100/mL, hemoglobin of 8.4g/dL and positive systemic lupus erythematosus antibodies (anti-Ro/SSA, anti-La/SSB, anticardiolipin, and antinuclear antibodies); blood culture was positive for Streptococcus gallolyticus. Three-dimensional transesophageal echocardiography was performed and revealed multiple mitral valve vegetations, with leaflet perforation and important mitral regurgitation, as well as large aortic vegetation, with cusp perforation and severe regurgitation. Additionally, a small vegetation was observed on the tricuspid valve, which presented moderate regurgitation. Threedimensional transesophageal echocardiography provides appropriate visualization of complications resulting from infectious endocarditis.
authors.forename: Rudyney Eduardo Uchôa de
authors.initials: RE
authors.lastname: Azevedo
authors.forename: Ana Clara Tude
authors.initials: AC
authors.lastname: Rodrigues
authors.forename: Lucas Arraes de
authors.initials: LA
authors.lastname: França
authors.forename: Maria Luciana Zacarias Hannouche da
authors.initials: ML
authors.lastname: Trindade
authors.forename: Marcelo Luiz Campos
authors.initials: ML
authors.lastname: Vieira
authors.forename: Claudio Henrique
authors.initials: CH
authors.lastname: Fischer
authors.forename: Samira Saady
authors.initials: SS
authors.lastname: Morhy
mesh_terms: D000328:Adult; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000382:microbiology*; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis*; D008943:Mitral Valve / Q000000981:diagnostic imaging; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology*; D013291:Streptococcus / Q000302:isolation & purification*