ABSTRACT
We report a case of renal embolism as an initial manifestation of Streptococcus dysgalactiae subspecies equisimilis (SDSE) endocarditis in a patient with chronic aortic dissection. A 37-year-old man who underwent total aortic arch replacement owing to aortic dissection, presented with a 3-h history of fever, chills, and acute right-sided flank pain. The endocarditis affected the native aortic valve and was complicated by a renal embolism. Blood culture results were positive for SDSE. Intravenous penicillin resulted in satisfactory clinical and echocardiographic recovery.
Subject(s)
Aortic Aneurysm/complications , Endocarditis/complications , Renal Artery Obstruction/microbiology , Streptococcal Infections/complications , Streptococcus/isolation & purification , Thromboembolism/microbiology , Administration, Intravenous , Adult , Aortic Dissection/complications , Anti-Bacterial Agents/administration & dosage , Chronic Disease , Endocarditis/drug therapy , Endocarditis/microbiology , Humans , Male , Penicillins/administration & dosage , Renal Artery Obstruction/complications , Streptococcal Infections/drug therapy , Streptococcus/classification , Streptococcus/pathogenicity , Thromboembolism/complications , Treatment OutcomeABSTRACT
Streptococcus pneumoniae is a rare pathogen of sepsis in patients with antithyroid drug-induced agranulocytosis. We herein describe a case of antithyroid drug-induced agranulocytosis complicated by pneumococcal sepsis and upper airway obstruction. A 27-year-old woman who was previously prescribed methimazole for nine months presented with a four-day history of a sore throat. She nearly choked and was diagnosed with febrile agranulocytosis. She was successfully treated with intubation, intravenous antibiotics and granulocyte colony-stimulating factor. Her blood cultures yielded S. pneumoniae. Emergency airway management, treatment of sepsis and the administration of granulocyte colony-stimulating factor can improve the clinical course of antithyroid drug-induced pneumococcal sepsis in patients with airway obstruction.
