title: A case of infective endocarditis along with a ruptured valve caused byStreptococcus agalactiaein an immunocompetent man.
abstract: Streptococcus agalactiae(S. agalactiae) is a major cause of invasive disease in neonates and pregnant women, but has also recently been observed among non-pregnant adults, especially elderly persons or persons with underlying chronic disease.S. agalactiaeis also a rare cause of infective endocarditis, and most cases require early surgery. We report the case of a 43-year-old previously healthy man who experienced rapid progressive culture-negative infective endocarditis with aortic valve vegetation and severe aortic regurgitation, which was complicated by lumbar spondylodiscitis. Emergency aortic valve replacement was performed on the day of his admission, which revealed a congenital bicuspid aortic valve was ruptured by the vegetation. The resected aortic valve specimen was submitted for 16S ribosomal RNA gene sequencing, which revealed that the pathogen wasS. agalactiae. Therefore,S. agalactiaeshould be considered a potentially causative pathogen in cases of rapid progressive infective endocarditis, even if it occurs in a non-pregnant immunocompetent adult.
authors.affiliation: Department of General Medicine, Juntendo University Faculty of Medicine, Japan.
authors.forename: Kiyozumi
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of General Medicine, Juntendo University Faculty of Medicine, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirai
authors.affiliation: Department of General Medicine, Juntendo University Faculty of Medicine, Japan.
authors.forename: Fujiko
authors.initials: F
authors.lastname: Morita
authors.affiliation: Department of General Medicine, Juntendo University Faculty of Medicine, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Uehara
authors.affiliation: Department of General Medicine, Juntendo University Faculty of Medicine, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Oshima
authors.affiliation: Department of General Medicine, Juntendo University Faculty of Medicine, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Mitsuhashi
authors.affiliation: Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Amano
authors.affiliation: Department of General Medicine, Juntendo University Faculty of Medicine, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Naito
keywords: 16S ribosomal RNA gene sequencing; Bicuspid aortic valve; Culture-negative endocarditis; Immunocompetent; Spondylodiscitis; Streptococcus agalactiae