PROSTHETIC VALVE ENDOCARDITIS CAUSED BY STREP EQUI

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: One must consider prosthetic valve endocarditis in patients with heart valves and an infection of uncertain origin. It is important to zoonotic origins at risk patients. The following case examines a patient who developed from streptococci. CASE PRESENTATION: 28 year old Amish male past medical history Shone's syndrome status-post surgical repair 2004, redo sternotomy 2018 presented the hospital sudden persistent fever for three days. Social included maintaining horses. Initial labs revealed leukocytosis 10.3 (normal 4.5-10.0 thou/cmm), elevated C-reactive protein 14.74 0.00-0.50 mg/dL), erythrocyte sedimentation rate 45 0-15 mm/hr), procalcitonin 9.58 0.02-0.09 ng/mL). A CTA chest (Figure 1) confirmed aortic abscess. Blood cultures returned positive streptococcus equi. patient's empiric antibiotics were transitioned ceftriaxone vancomycin penicillin gentamicin. then underwent another was scheduled follow-up infectious disease cardiology as outpatient. DISCUSSION: Streptococcus equi subspecies zooepidemicus type most often associated rare human transmission. commensal organism upper respiratory tract lower genital horses.1 may be transmitted via consumption unpasteurized milk or direct contact horses, through gastrointestinal systems, openings skin.2 B- lactam are considered choice group C streptococcus, which includes equi, addition aminoglycosides seem favorable severe cases. True underestimated due difficulty identifying pathogen.3 CONCLUSIONS: reporting system would help better quantify developing after exposure In turn, this could lead guideline-driven approach preventative measures1 outside regular hygiene, such prophylactic antibiotics, avoidance. REFERENCE #1: 1.Sleutjens J, Meijer D, Meregalli PG, et al. Zoonotic Endocarditis Man, Netherlands. Emerg Infect Dis. 2019;25(1):180-182. #2: 2.Poulin M-F Boivin G. disseminated caused by zooepidemicus. Canadian journal diseases & microbiology = Journal canadien des maladies infectieuses de la microbiologie medicale. https://pubmed.ncbi.nlm.nih.gov/20514161/. Published 2009. Accessed March 4, 2021. #3: 3.Daubié AS, Defrance C, Renvoisé A, Illustration Difficulty Identifying Strains Subspecies Level Immunocompetent Man. J Clin Microbiol. 2014;52(2):688-691. DISCLOSURES: No relevant relationships Nathaniel Gilbert, source=Web Response Andrei Hastings, Randol Kennedy,