Tricuspid Infective Endocarditis Caused by Streptococcus Agalactiae After an Elective Abortion

Abstract

Introduction: Streptococcus agalactiae, also known as Group B Streptococcus, is increasingly causing invasive diseases in non-pregnant women and elderly adults. This includes infective endocarditis after elective abortion, with a rising incidence and more severe outcomes compared to other streptococcal infections. Clinical practice must focus on early diagnosis and appropriately managing this rare but severe complication. Our case report discusses a case
of Streptococcus agalactiae infective endocarditis following an elective abortion.

Case: A 25-year-old female, one-month post-elective abortion, presented with dyspnea, yellow blood-tinged sputum, chest pain, and migratory arthralgia. Physical examination revealed tachycardia, tachypnea, reduced air entry, and joint tenderness. Blood work showed elevated WBC, lactic acid, and procalcitonin, with blood cultures positive for group B streptococcus agalactia. Imaging revealed pulmonary infiltrates, pericardial effusion, and Hepatosplenomegaly. Antibiotics (Rocephin, azithromycin, vancomycin) and steroids were administered, with limited improvement. Transesophageal echocardiogram (TEE) revealed tricuspid valve vegetations, leading to a switch to Ceftriaxone for six weeks due to subacute presentation.

Conclusion: Streptococcus agalactiae infective endocarditis is a rare but severe complication, particularly in non-pregnant adults. The incidence of this condition following elective abortion has raised concerns about the need for increased awareness and proactive measures in clinical practice. Recognizing early symptoms and implementing appropriate care is crucial due to the potentially high mortality rate associated with this infection. More research is
needed to improve patient outcomes and reduce morbidity and mortality from this emerging complication.