@article{3103731,
    title = "Human disease caused by Streptococcus alactolyticus: A case report of native valve infective endocarditis and review of the literature",
    author = "Mylonas, C.C. and Gomatou, G. and Poulakou, G. and Moraitou, E. and Syrigos, K.",
    journal = "Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace",
    year = "2020",
    volume = "90",
    number = "4",
    pages = "638-641",
    publisher = "Page Press Publications",
    doi = "10.4081/MONALDI.2020.1428",
    keywords = "amoxicillin plus clavulanic acid;  ampicillin;  beta adrenergic receptor blocking agent;  C reactive protein;  cefalotin;  cefotaxime;  ceftriaxone;  cefuroxime;  chloramphenicol;  ciprofloxacin;  daptomycin;  dipeptidyl carboxypeptidase inhibitor;  erythromycin;  gentamicin;  glucose;  hydroxymethylglutaryl coenzyme A reductase inhibitor;  imipenem;  insulin;  levofloxacin;  lincomycin;  nonsteroid antiinflammatory agent;  penicillin derivative;  piperacillin;  streptomycin;  technetium 99m;  teicoplanin;  tetracycline;  tigecycline;  tobramycin;  troponin;  vancomycin;  antiinfective agent, abdominal pain;  adult;  antibiotic therapy;  Article;  bacterial endocarditis;  blood culture;  body weight loss;  brain;  case report;  chorioamnionitis;  clinical article;  clinical examination;  colonoscopy;  computer assisted tomography;  elevated blood pressure;  erythrocyte sedimentation rate;  fever;  follow up;  fourth lumbar vertebra;  glucose blood level;  human;  hypertension;  intervertebral disk hernia;  low back pain;  male;  middle aged;  mitral valve;  mitral valve prolapse;  mitral valve regurgitation;  mitral valve replacement;  newborn;  non insulin dependent diabetes mellitus;  nuclear magnetic resonance imaging;  percutaneous coronary intervention;  Q wave;  radiodiagnosis;  scintigraphy;  spine;  spleen infarction;  spondylitis;  ST segment depression;  Streptococcus;  Streptococcus alactolyticus;  tooth abscess;  transesophageal echocardiography;  transthoracic echocardiography;  treatment duration;  abdominal pain;  aftercare;  aged;  bacterial endocarditis;  complication;  diagnostic imaging;  female;  isolation and purification;  microbiology;  mitral valve prolapse;  pathology;  procedures;  Streptococcus;  treatment outcome;  x-ray computed tomography, Abdominal Pain;  Adult;  Aftercare;  Aged;  Anti-Bacterial Agents;  Blood Culture;  Echocardiography, Transesophageal;  Endocarditis, Bacterial;  Female;  Humans;  Infant, Newborn;  Male;  Middle Aged;  Mitral Valve;  Mitral Valve Prolapse;  Splenic Infarction;  Streptococcus;  Tomography, X-Ray Computed;  Treatment Outcome",
    abstract = "Streptococcus alactolyticus, a member of the Streptococcus bovis/Streptoccus equinus complex, is primarily hosted in the gastrointestinal tract of animals and rarely of humans, with only scarce reports relating to human disease. We herein present a case of subacute infective endocarditis (IE) caused by S. alactolyticus in a 64-year old male with pre-existing mitral prolapse. Despite a 10-month history of low-grade fever and weight loss, the diagnosis of IE was triggered by left quadrant abdominal pain which revealed splenic infarcts on computed tomography. A definitive diagnosis of IE was subsequently established by four consecutive blood cultures positive for S. alactolyticus plus demonstration of a vegetation on the mitral valve by trans-esophageal ultrasound. Further workup revealed multiple embolic phenomena including brain and spine. A dental abscess was identified as the most probable origin of the bacteraemia, while colonoscopy revealed no evidence of cancer. Although rare, IE caused by S. alactolyticus may be severe and of obscure origin; oral cavity should not be overlooked as a possible origin. Attention should be given in patients with preexisting risk factors. © The Author(s), 2020 Licensee PAGEPress, Italy Monaldi Archives for Chest Disease 2020; 90:1428"
}