title: Severe infective endocarditis in a healthy adult due to Streptococcus agalactiae.
abstract: A case of severe endocarditis, with complications of multiple infarction, meningitis, and ruptured mitral chordae tendineae, caused by Streptococcus agalactiae in a healthy man, is reported. Emergency cardiovascular surgery was performed on the day of admission. Infective endocarditis caused by S. agalactiae is very rare, particularly in a healthy adult. In addition, microbiological analysis revealed that S. agalactiae of sequence type (ST) 19, which belongs to serotype III, was present in the patient's vegetation, mitral valve, and blood culture. It was therefore concluded that the endocarditis was caused by ST19, which has been reported as a non-invasive type of S. agalactiae. This was an extremely rare case in which S. agalactiae of ST19 caused very severe endocarditis in an adult patient with no underlying disease.
authors.affiliation: Department of Infection Control and Prevention, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Microbiology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fujita
authors.affiliation: Department of Infection Control and Prevention, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Electronic address: task300@tokyo-med.ac.jp.
authors.forename: Itaru
authors.initials: I
authors.lastname: Nakamura
authors.affiliation: Department of Infection Control and Prevention, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Microbiology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Tsukimori
authors.affiliation: Department of Infection Control and Prevention, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Microbiology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Ohkusu
authors.affiliation: Department of Microbiology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D020520:Brain Infarction / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000382:microbiology; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*
keywords: Healthy; Infective endocarditis; Non-invasive strain; Severe; Streptococcus agalactiae