HYBRID EVENT: You can participate in person at Rome, Italy or Virtually from your home or work.

3rd Edition of International Heart Congress

June 05-07,2025 | Hybrid Event

June 05 -07, 2025 | Rome, Italy
Heart Congress 2025

A fatal case of group B strep endocarditis

Bhavya Parikh, Speaker at Heart Conferences
North Shore-Long Island Jewish, United States
Title : A fatal case of group B strep endocarditis

Abstract:

Streptococcus agalactiae, commonly known as Group B strep (GBS), is an uncommon pathogen in most adults and is typically only seen in pregnant women and neonates. Local and systemic complications from GBS typically have a high mortality rate, with infective endocarditis (IE) being aggressive and deadly. We present a rare case of GBS IE in an 85-year-old female with a history of chronic lower extremity wounds that presented with acute left knee pain. Patient was found to have a septic joint and underwent an I&D. Surgical cultures were obtained growing GBS. Patient was started on IV ceftriaxone; but soon after, the patient started developing severe dyspnea. TTE showed mobile echodensity associated with posterior mitral valve leaflet with severe mitral regurgitation and pulmonary hypertension. Repeat blood cultures grew GBS in 4/4 bottles. A TEE was performed showing a mycotic aneurysm and an aortic root abscess. A shared decision with the patient and family was made to not pursue surgical intervention. Patient was managed with IV ceftriaxone through a PICC line for six weeks. Patient re-presented with severe dyspnea and hypoxia, wide complex tachycardia, and atrial fibrillation shortly after discharge. Goals of care were discussed with the patient and family who opted for comfort care. Patient expired shortly after. GBS presents with an especially aggressive phenotype of lE among streptococcus species, and mortality rates can be as high as 40%. Complications are common and they include systemic embolization, severe valvular dysfunction, mycotic aneurysms, arrhythmias, and heart failure, which often present acutely. Shared decision-making involving the patient, family, and interdisciplinary team of CT surgeons, interventional cardiologists, infectious disease, and palliative care teams remains important. Future studies are needed to evaluate outcomes between surgical/endovascular intervention of the valves vs. long-term antibiotics vs. a combination of both.

Biography:

Bhavya Parikh is a PGY-3 now finishing his Internal Medicine Residency in New York and wants to pursue a cardiology fellowship. He obtained his MD from Meharry Medical College in Nashville with a cum laude distinction and finished his undergraduate studies at University of Tennessee with Magna cum laude distinction. He has multiple research interests spanning translational and clinical medicine in Cardiology and has published in various high achieving journals while in residency and medical school.

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