Hakuna mycotic aneurysm, Streptococcus salivarius does not always mean "no worries". (September 2021)

• Record Type: Journal Article
• Authors: Ahmad, Saad; Song, David; Reyes, Jonathan Vincent M.; Whiting, Adrian; Almas, Talal; Lieber, Joseph J.
• Is Part Of: Annals of medicine and surgery. Volume 69(2021)
• Publication Date: 2021-09
• Subjects: Mycotic aneurysm -- Endocarditis -- Viridans -- Streptococcus -- Duke criteria -- Bacteremia; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102798
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Streptococcus salivarius, an easily missed and commonly disregarded Viridians strep species, is usually written off as a culture contaminant, but has been implicated as a rare cause of bacterial endocarditis with serious complications. It is a normal commensal microorganism of the mouth and gut, S. salivarius is usually harmless and even demonstrates anti-inflammatory properties. However, the literature about the complications of a S. salivarius bacteremia remains unclear. This case highlights a patient with mycotic aneurysms due to infective endocarditis in the setting of S. salivarius bacteremia. Highlights: Streptococcus salivarius is easily missed and usually a culture contaminant, but it is also a rare cause of bacterial endocarditis with serious complications. Infective endocarditis is diagnosed based on the modified Duke's criteria and commonly presents with a low-grade fever, a new onset heart murmur, petechiae, subungual hemorrhages, Janeway lesions, Osler nodes, or Roth spots. It is critical to recognize S. salivarius 's role in bacterial endocarditis and its serious complications; therefore, rapid identification and treatment with antibiotics are imperative to avoid complications.