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.
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.
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.
Trivalle C, Martin E, Martel P, et al. Group B streptococcal bacteriemia in the elderly. J Med Microbiol. 1999;47:649–52. CrossRef
Lawrence YR, Pokroy R, Berlowits D, et al. Splenic infarction: an update on William Osler’s observations. IMAJ. 2010;12:362–5. PubMed
Chaudhari D, Saleem A, Patel P, et al. Hepatic artery mycotic aneurism associated with staphylococcal endocarditis with successful treatment: case report with review of the literature. Case Report Hepatol. 2013; 10.1155/2013/610818Epub 2013 May 12.
- Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic aneurysms and massive splenic infarction: a case report
Matilde De Simone
- BioMed Central
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