Presentation Date
19-10-2021 12:00 AM
Description
Introduction: Group B Streptococcus is a gram-positive beta hemolytic streptococcus species commonly colonizing the genitourinary tract of females. Although it contributes to a variety of infections, group B strep is increasing in frequency in its rare manifestation of infective endocarditis in many non-pregnant women. Our case presents an uncommon complication of a necrotic uterine leiomyoma with a concurrent rare presentation of group B Streptococcus endocarditis in a previously asymptomatic 39-year-old nulliparous female. Case: We present a case of a 39-year-old female with a history of iron deficiency anemia and a uterine leiomyoma incidentally found on imaging who presented to an outside hospital with a 5- day history of worsening shortness of breath associated with dyspnea on exertion and a mild, nonproductive cough. Blood cultures were later speciated as group B Streptococcus. A TEE revealed an aortic root abscess and severe aortic and mitral/tricuspid valve regurgitation, and the patient subsequently received a mechanical aortic valve replacement. A successful hysterectomy was later performed due to concern for degenerating fibroids as the nidus of infection. The final diagnoses included group B streptococcus endocarditis with a perivalvular abscess secondary to necrotic uterine fibroids. Discussion: Our patient did not have the traditional risk factors associated with GBS endocarditis including malignant disease, diabetes, alcoholism, injection drug use, cirrhosis, or an elective abortion. Although our patient suffered with common symptoms reported from the previously reported pyomyomas, GBS endocarditis had only been with associated with one of these cases. Further literature review revealed only one other case of GBS endocarditis which had been reported in the setting of an infected uterine fibroid. Conclusion: In the event of a diagnosed case of group B streptococcus endocarditis, there should be consideration for an infected uterine source leading to group B streptococcus bacteremia in a previously healthy non-pregnant female.
Recommended Citation
Quiring, Robert and Robertson, Jared, "Group B Streptococcus infective endocarditis due to necrotic leiomyoma: a case report" (2021). Medical Research Day. 91.
https://digitalscholar.lsuhsc.edu/sommrd/2021MRD/Posters/91
Included in
Group B Streptococcus infective endocarditis due to necrotic leiomyoma: a case report
Introduction: Group B Streptococcus is a gram-positive beta hemolytic streptococcus species commonly colonizing the genitourinary tract of females. Although it contributes to a variety of infections, group B strep is increasing in frequency in its rare manifestation of infective endocarditis in many non-pregnant women. Our case presents an uncommon complication of a necrotic uterine leiomyoma with a concurrent rare presentation of group B Streptococcus endocarditis in a previously asymptomatic 39-year-old nulliparous female. Case: We present a case of a 39-year-old female with a history of iron deficiency anemia and a uterine leiomyoma incidentally found on imaging who presented to an outside hospital with a 5- day history of worsening shortness of breath associated with dyspnea on exertion and a mild, nonproductive cough. Blood cultures were later speciated as group B Streptococcus. A TEE revealed an aortic root abscess and severe aortic and mitral/tricuspid valve regurgitation, and the patient subsequently received a mechanical aortic valve replacement. A successful hysterectomy was later performed due to concern for degenerating fibroids as the nidus of infection. The final diagnoses included group B streptococcus endocarditis with a perivalvular abscess secondary to necrotic uterine fibroids. Discussion: Our patient did not have the traditional risk factors associated with GBS endocarditis including malignant disease, diabetes, alcoholism, injection drug use, cirrhosis, or an elective abortion. Although our patient suffered with common symptoms reported from the previously reported pyomyomas, GBS endocarditis had only been with associated with one of these cases. Further literature review revealed only one other case of GBS endocarditis which had been reported in the setting of an infected uterine fibroid. Conclusion: In the event of a diagnosed case of group B streptococcus endocarditis, there should be consideration for an infected uterine source leading to group B streptococcus bacteremia in a previously healthy non-pregnant female.