Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic aneurysms and massive splenic infarction: a case report

BMC Gastroenterology

卷:17

Luca Fumagalli¹  Marco Chiarelli¹  Angelo Guttadauro²  Sabina Terragni²  Francesco Gabrielli²  Ugo Cioffi³  Matilde De Simone³  Paolo Bonfanti⁴  Pietro Achilli⁵ 

[1] Department of Surgery, Ospedale Alessandro Manzoni, Lecco;

[2] Department of Surgery, University of Milan-Bicocca, Istituti Clinici Zucchi;

[3] Department of Surgery, University of Milan;

[4] Infectious Diseases Unit - A. Manzoni Hospital;

[5] University of Milan - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico;

关键词: Hepatic artery aneurysm;    Splenic infarction;    Infective endocarditis;    Streptococcus agalactiae;   

DOI  :  10.1186/s12876-017-0728-0

来源: DOAJ

【 摘 要 】

Abstract Background The burden of disease caused by Streptococcus agalactiae has increased significantly among older adults in the last decades. Group B streptococcus infection can be associated with invasive disease and severe clinical syndromes, such as meningitis and endocarditis. Case presentation We present the case of a 56-year-old man who developed multiple mycotic aneurysms of the right hepatic artery and massive splenic infarction as rare complications of Streptococcus agalactiae infective endocarditis. The patient underwent urgent right hepatic artery ligation and splenectomy. The postoperative course was complicated by an episode of hemobilia due to the rupture of a partially thrombosed mycotic aneurysm into the biliary tree. Thus, selective radiological embolization of the left hepatic artery branches was necessary. Conclusion To our knowledge, this is the first case reported of infected aneurysms of visceral arteries caused by Group B streptococcus infection. Clinical and laboratory findings were non-specific, while imaging features with computed tomography scan and angiography were highly suggestive. In our case, early recognition, culture-specific intravenous antibiotics and urgent surgical treatment combined with interventional radiology played a decisive role in the final result.

【 授权许可】

Unknown