Roig-Marín N, Roig-Rico P, Calbo-Maiques J, Seguí-Ripoll JM

Language: Spanish
References: 13
Page: 1296-1299
PDF size: 228.14 Kb.

ABSTRACT

Background: Streptococcus intermedius together with S. anginosus and S. constellatus form the group S. anginosus (previously called S. milleri), anteriorly considered a type of S. viridans. Sometimes they can cause infections with a tendency to abscess at the liver and brain, but it is rare to find it as an etiologic agent of endocarditis, spondylodiscitis and epidural abscess. Therefore, the coexistence of the three locations is exceptional.
Clinical cases: A 72-year-old male patient was hospitalized because of decreased level of consciousness with aphasia. The patient reported low back pain with mechanical characteristics. During the first day, he presented a feverish peak and blood cultures were extracted in which Streptococcus intermedius grew. On lumbar spine MRI, spondylodiscitis was reported on L4-L5 and abscess in the anterior epidural space at the L5 level. A transesophageal echocardiogram was also performed, which showed two warts in the aortic and mitral valves. It was decided to give surgical treatment with valve replacement with a metallic mitral prosthesis. The epidural abscess was cured after antibiotic treatment.
Conclusions: In a patient with S. intermedius endocarditis, the aggressiveness of the germ and the tendency to form abscesses in different locations must be taken into account. The presence of low back pain forces to rule out spondylodiscitis and an epidural abscess.

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