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Native Mitral Valve Endocarditis Caused by Peptostreptococcus Following Rupture of a Dental Root Abscess: Case Report and Literature Review

Binna M. Chokshi, Andrew Chu, Daniel Kaswan

(Department of Internal Medicine, Aventura Hospital and Medical Center, Aventura, FL, USA)

Med Sci Case Rep 2016; 3:13-16

DOI: 10.12659/MSCR.897963


BACKGROUND: Peptostreptococcus is a genus of gram-positive, anaerobic, non-spore-forming bacteria. These microbes commonly colonize the oropharynx. Common infection sites range from skin and soft tissues to CNS, head, neck, chest, abdomen, pelvis, bones, and joints. Rare occurrences of endocarditis caused by this bacterium have been reported.
CASE REPORT: We encountered a 29-year-old Haitian man with past medical history of deep venous thrombosis on anticoagulation who presented with complaint of right-sided chest pain. He was subsequently diagnosed with infective endocarditis with evidence of valvular vegetation on echocardiogram and blood cultures growing Peptostreptococcus micros. He underwent cardiothoracic surgery and was treated with an extended course of intravenous antibiotic.
CONCLUSIONS: Peptostreptococcus endocarditis is very rare and Peptostreptococcus endocarditis arising from dental procedures or dental infections are even more rare. We present a review of the literature and a specific case report to improve understanding of an association between Peptostreptococcus endocarditis and dental pathology. Our review indicates that Peptostreptococcus endocarditis, despite its relative scarcity, should be consider as a differential diagnosis for a patient with history of dental procedure or infection.
This paper recognizes the importance of detail history, physical examination, and a broad differential diagnosis in the setting of Infective endocarditis. Early recognition of Peptostreptococcus as the causative agent of infective endocarditis in a patient after dental pathology is critical for initiating early antibiotic treatment.

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