title: Endocarditis caused by unusual Streptococcus species (Streptococcus pluranimalium).
abstract: BACKGROUND
  Infective endocarditis in intravenous drug abusers is caused mainly by Staphylococcus species and usually affects the right heart valves.
  
  
  METHODS
  We report the case of a 37-years-old intravenous drug abuser, who was diagnosed with infective endocarditis of the mitral and aortic valve. An unusual Streptococcus species (Streptococcus pluranimalium) was isolated from surgical specimens (peripheral arterial emboli, valves' vegetations) which, according to the literature, is related to animals' diseases such as infective endocarditis in adult broiler parents, with no references existing regarding causing such disease in humans. This unusual coccus infection caused specific clinical features (sizable vegetation on mitral valve >2cm, smaller vegetations on aortic valve, systemic emboli), resistance to antimicrobial therapy, rapid progression of the disease (despite of medical therapy and surgical replacement of both valves), and finally the death of the patient two months after the initial presentation of infective endocarditis.
  
  
  CONCLUSIONS
  Unusual cases of infective endocarditis in intravenous drug abusers are emerging and are characterized by changing microbiological profile and varying clinical characteristics. Clinical doctors must be aware of these cases, especially when their patients present an atypical clinical course, and reappraise their medical management. Hippokratia 2015; 19 (2):182-185.
authors.affiliation: 3 Cardiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Fotoglidis
authors.affiliation: 3 Cardiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Pagourelias
authors.affiliation: 3 Cardiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Kyriakou
authors.affiliation: 3 Cardiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Vassilikos
keywords: Streptococcus pluranimalium; drug abuser; infective endocarditis