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Infective endocarditis during
breastfeeding is rare. To the best of the authors’
knowledge, this is the second recorded case of
infective endocarditis in a lactating
mother. It is known that
women of
child-bearing age are susceptible to
infective endocarditis during
pregnancy when the
immune system is compromised.1 Nevertheless, past cases were also exposed to a systemic
infection via
milk infected by their
infant’s oral commensal.
Streptococcus mitis (S.Mitis)
endocarditis in
pregnancy has also been reported, whereby a lady delivered via
caesarean section and underwent
mitral valve reconstruction and annuloplasty.1 S. mitis is considered a pioneer streptococci commensal in
human oral mucosa, appearing as early as 1-3 days after delivery.2 As a
child grows, their
oral mucosa will be colonized by more
viridans streptococci, including the
teeth,
oropharynx and
nasopharynx. In a
mother who breastfeeds, a crack in the
nipple and
breast engorgement can be
predisposing factors for systemic
infection stemming from an
infant’s oral commensal. Both cases of
breastfeeding-related
infective endocarditis caused by pioneer
streptococcus viridans, S.mitis in our
report and S.salivarius3 in the previous
report, affected the left-sided valves