A case of endocarditis caused by Streptococcus sinensis
Background: Streptococcus sinensis was encountered for the first time in China in 2002 as a cause of invasive disease, and its natural distribution and geographic association with Asia have been questioned since. In the sporadic reports of non-Asian cases of infection with Streptococcus sinensis the patient's travel history, necessary to disprove a link with Asia, was seldom documented.  Case presentation: We describe a case of Streptococcus sinensis bacteremia due to a possible endocarditis where the patient is of Dutch origin, and has a negative travel history to Asia. This first-time demonstrates an autochthonous infection with Streptococcus sinensis in the Netherlands.  Publicly available metagenomic data in the microbiome atlas project further shows that Streptococcus sinensis is worldwide present in the human microbiome, including in numerous samples from the Netherlands. Conclusions: Streptococcus sinensis is commonly present in the human microbiome globally, and although infections are rare, positive blood cultures with Streptococcus sinensis should alarm clinicians for it is associated with infective endocarditis.