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Sudden death due to infective endocarditis caused by Streptococcus constellatus: A case report

Zamasry MS, Hilmi Z, Mohd Yusof MYP, Razali HSA, Nawawi H, Mahmood MS

Trop Biomed, 2019 Dec 01;36(4):845-849.

Infective endocarditis (IE) is a relatively uncommon disease, but has been challenging to diagnose over the years. With the increasing incidence, variety of causative agents and the resistance of microorganisms towards antibiotics, there is still an occurrence of sudden death due to undiagnosed IE. The most common microorganism causing IE is Staphylococcus aureus. However, there is increasing prevalence of other microorganisms causing IE. This case report highlights a case of sudden death due to IE caused by a rare pathogen, Streptococcus constellatus which belongs to the Streptococcus anginosus group (Milleri group). A study noted the crude incidence of IE in 6 world regions ranged between 1.5 and 11.6 cases per 100,000 people. To date, there has been no previous report on sudden death due to IE caused by Streptococcus constellatus in Malaysia, neither in the forensic nor clinical setting. This case report underlined the characteristics and pathological features of this microorganism. The increasing incidence and variety of causative organisms in IE are important public health issues. It is vital for future studies to examine the risk factors of IE related to Streptococcus constellatus, to enhance better understanding, insight and awareness regarding the course of this disease. This in turn may facilitate preventive measures to avoid morbidity and mortality from this condition.

Matched MeSH terms: Streptococcal Infections/diagnosis*

Fulltext Case report: two human Streptococcus suis infections in Borneo, Sabah, Malaysia

Rajahram GS, Hameed AA, Menon J, William T, Tambyah PA, Yeo TW

BMC Infect Dis, 2017 03 04;17(1):188.

PMID: 28257622 DOI: 10.1186/s12879-017-2294-z

BACKGROUND: Streptococcus Suis (S.suis) is increasingly being recognised as a potentially preventable emerging zoonotic infection in humans with a global distribution. It is a major cause of meningitis especially among those in contact with pigs and has also been associated with a toxic shock syndrome.

CASE PRESENTATIONS: We report the first two human cases from Sabah, Borneo, Malaysia which expands the global reach of this important pathogen. Here, we illustrate their epidemiological risk factors, clinical presentation and resulting sequelae of both patients.

CONCLUSION: The continued public health threat of zoonotic infections such as S.suis, highlights the need for accurate epidemiological surveillance, regulation of pig farming, slaughtering and continued advocacy of best practices for pork preparation and consumption.

Matched MeSH terms: Streptococcal Infections/diagnosis*

Group B streptococcal infection in the newborn

Kwan PW, Khoo BH, Lam KL, Puthucheary SD

Med J Malaysia, 1979 Sep;34(1):71-5.

PMID: 396463

Matched MeSH terms: Streptococcal Infections/diagnosis*

Fulltext Neonatal group B beta-haemolytic streptococcal infection in Kuala Lumpur

Minhaj AA, Jamal F, Mohamed R

Med J Malaysia, 1980 Dec;35(2):117-21.

PMID: 7022149

First six cases of neonatal group B beta-haemolytic streptococcal sepsis in GHKL & Maternity Hospital K.L. were reported and in one third, it was fatal. Five of the cases were 'early - onset' type and one was 'late - onset' type. While maternal infant transmission of the disease is important in the 'early - onset' type, environmental sources of infection are also significant. No gestational age or birthweight is spared from the disease. Finally, there are cases of 'early - onset' GBS sepsis presenting like hyaline membrane disease of the newborn and it is important to find ways to distinguish them which so far has not been satisfactory.

Matched MeSH terms: Streptococcal Infections/diagnosis*

Fulltext Endophthalmitis with bilateral deafness from disseminated Streptococcus suis infection

Rayanakorn A, Katip W, Lee LH, Oberdorfer P

BMJ Case Rep, 2019 Feb 26;12(2).

PMID: 30814105 DOI: 10.1136/bcr-2018-228501

Streptococcus suis is a Gram-positive cocci bacterium that are found mainly in pigs and can be transmitted to human through pigs or pork exposure. The disease is mainly found among occupations involving swine contact in western countries whereas in Asia the disease is usually contracted through raw pork consumption. In this case report, we present a case of a middle-aged Thai man who acquired the infection from raw pork consumption. He presented with endogenous endophthalmitis with infective spondylodiscitis, sepsis and meningitis and later developed blindness of the right eye and permanent bilateral hearing loss disseminated from S. suis infection. Our report suggests that S. suis infection be considered as a causative factor in patient presenting with established clinical symptoms and predisposing factors. Cultural habit of eating raw pork should be taken into account especially in Asian countries.

Matched MeSH terms: Streptococcal Infections/diagnosis*

Pyopneumothorax secondary to Streptococcus milleri infection

Che Rahim MJ, Mohammad N, Wan Ghazali WS

BMJ Case Rep, 2016 Nov 23;2016.

PMID: 27881590 DOI: 10.1136/bcr-2016-217537

We report a case of a 46-year-old Malay woman with underlying hypothyroidism post thyroidectomy who presented with worsening breathlessness, orthopnoea, productive cough and left-sided pleuritic chest pain of 3 days duration. Chest X-ray on admission showed left-sided massive hydropneumothorax. Pleural tapping revealed empyema. A chest tube was inserted immediately. The culture of pleural fluid grew Streptococcus constellatus The patient was treated with antibiotics for a total of 6 weeks and underwent open thoracotomy and decortication during admission. Subsequently, her lung condition improved and there was no evidence of recurrence during follow-up.

Matched MeSH terms: Streptococcal Infections/diagnosis

Fulltext Streptococcal pharyngitis in a primary care clinic

Foong HB, Yassim M, Chia YC, Kang BH

Singapore Med J, 1992 Dec;33(6):597-9.

PMID: 1488669

A study to determine the sensitivity and specificity of the Directogen Group A Streptococcal Test was carried out in a primary care clinic in University Hospital, Kuala Lumpur. The study also looked at the prevalence of streptococcal pharyngitis in the clinic. We found that the rapid test has a sensitivity of 90.9% and a specificity of 90.7%. Viral pharyngitis is the commonest form (63%) of pharyngitis followed by Group A Beta haemolytic streptococcal pharyngitis (14.2%). The presence of exudates, tonsillar enlargement and the presence of tender cervical lymph nodes have a significantly higher association with streptococcal pharyngitis.
Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Streptococcal Infections/diagnosis*

Complications of chronic suppurative otitis media: a left otogenic brain abscess and a right mastoid fistula

Chew YK, Cheong JP, Khir A, Brito-Mutunayagam S, Prepageran N

Ear Nose Throat J, 2012 Oct;91(10):428, 430.

PMID: 23076851

Otogenic brain abscess and postauricular fistula are complications of chronic suppurative otitis media. We describe a rare case of bilateral chronic suppurative otitis media that caused a left temporal lobe abscess and a right mastoid fistula.

Matched MeSH terms: Streptococcal Infections/diagnosis

Fulltext Group B streptococcal bacteremia in a major teaching hospital in Malaysia: a case series of eighteen patients

Eskandarian N, Neela V, Ismail Z, Puzi SM, Hamat RA, Desa MN, et al.

Int J Infect Dis, 2013 Sep;17(9):e777-80.

PMID: 23453715 DOI: 10.1016/j.ijid.2013.01.011

Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults.

Matched MeSH terms: Streptococcal Infections/diagnosis

Late onset group b beta-hemolytic streptococcus infection in a neonate manifesting as a urinary tract infection: a rare clinical presentation

Zurina Z, Rohani A, Neela V, Norlijah O

Southeast Asian J. Trop. Med. Public Health, 2012 Nov;43(6):1470-3.

PMID: 23413711

Group B beta-hemolytic streptococcus (GBS) sepsis is a serious bacterial infection in neonates, with significant morbidity and mortality. We report here a neonate with late onset GBS infection manifesting as a urinary tract infection (UTI) in an infant presenting with prolonged neonatal jaundice. The pathogenesis of this late onset is postulated.

Matched MeSH terms: Streptococcal Infections/diagnosis*

Fulltext Travel-related Streptococcal toxic shock syndrome caused by emm type 78 Streptococcus pyogenes

Tappe D, Schulze MH, van der Linden M, Ziegler U, Müller A, Stich A

J Clin Microbiol, 2011 Aug;49(8):3094-5.

PMID: 21632896 DOI: 10.1128/JCM.02623-10

Streptococcal toxic shock syndrome is a serious health problem in developed and developing countries. We here report a case of severe protracted disease after a minor skin infection in a young traveler returning from West Malaysia which was caused by an unusual emm-type strain harboring speG and smeZ superantigen genes.

Matched MeSH terms: Streptococcal Infections/diagnosis*

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