Streptoccocus gordonii. A Rare Cause of Infective Endocarditis with Multiple Extracardiac Manifestations

Abstract

Introduction: The incidence of infective endocarditis is 3 to 7 per 100,000 inhabitants per year, and is considered the fourth most life-threatening infectious syndrome. Streptoccocus gordonii belongs to the normal flora of the oral cavity, upper respiratory tract, gastrointestinal system, and female genitalia. The clinical presentation of Streptoccocus gordonii infection can include infective endocarditis, septic arthritis, and spontaneous bacterial peritonitis. Streptoccocus gordonii does not tend to form abscesses, fistulas, or metastatic foci of infection in the vast majority of cases of infective endocarditis.

Objective: To analyze a clinical case of infective endocarditis that began with extracardiac manifestations.

Case report: This is a 63-year-old man who presented with lower back pain accompanied by paresthesias in both extremities, chills, profuse night sweats, weight loss, and fever, predominantly at night. He came for medical evaluation, and imaging studies diagnosed a grade III/VI diastolic aortic murmur. Lumbar MRI with infectious spondylodiscitis at the L4-L5 level. An echocardiogram was also performed, which revealed a 12-mm vegetation in the left coronary leaflet, associated with severe aortic regurgitation and grade III diastolic dysfunction.

Conclusions: Streptoccocus gordonii endocarditis is a rare phenomenon reported in the medical literature. The extracardiac manifestations, in this case manifested by spondylodiscitis, radiculopathy, fever, and weight loss, led to a search for an infectious source, primarily of cardiac origin.