A case of group G streptococcal endocarditis masquerading as acute rheumatic fever

Author:

Cameron Maureen1,Mosher Dianne23,Carson Julie34,Maitland Andrew35,Conly John M246

Affiliation:

1. Department of Internal Medicine, Queen’s University, Kingston, Ontario, Canada

2. Department of Medicine, University of Calgary, Calgary, Alberta, Canada

3. Alberta Health Services, Calgary, Alberta, Canada

4. Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

5. Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada

6. Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, Alberta, Canada

Abstract

Cases of infective endocarditis attributable to group G streptococci are uncommon, but may be more virulent and aggressive than viridans group streptococci. This case report documents an unusual presentation of group G streptococcal endocarditis in a previously healthy young man whose initial symptoms and signs of fever, migratory polyarthritis, subcutaneous nodule, new systolic murmur, polyarthralgias, and elevated C-reactive protein (CRP) in the presence of a markedly elevated anti-streptolysin O titre fulfilled three major clinical and three minor criteria of the Revised Jones criteria, leading to an initial working diagnosis of acute rheumatic fever before echocardiography. Clinicians need to be reminded of the masquerading features of infective endocarditis.

Publisher

University of Toronto Press Inc. (UTPress)

Subject

Infectious Diseases,Microbiology (medical)

Reference19 articles.

1. THE SEROLOGICAL DIFFERENTIATION OF PATHOGENIC AND NON-PATHOGENIC STRAINS OF HEMOLYTIC STREPTOCOCCI FROM PARTURIENT WOMEN

2. Infections Due to Lancefield Group G Streptococci

3. Wessels MR. Group C and group G streptococcal infection. In: Sexton DJ, editor. UpToDate. Waltham (MA): UpToDate; 2017. http://www.uptodate.com/contents/group-c-and-group-g-streptococcal-infection (Accessed June 30, 2017)

4. Infective Endocarditis Caused by Group G Streptococcus with Multiple Cerebral Emboli

5. Guidelines for the Diagnosis of Rheumatic Fever

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