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A complication of meningitis and infective endocarditis due to Streptococcus pyogenes
  1. Kosuke Inoue1,
  2. Akiyoshi Hagiwara2,
  3. Akio Kimura2,
  4. Norio Ohmagari3
  1. 1Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama, Japan
  2. 2Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Tokyo, Japan
  3. 3Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
  1. Correspondence to Dr Kosuke Inoue, kosuke.inoue1989{at}


We described a rare case of meningitis and infective endocarditis (IE) due to Streptococcus pyogenes. An 80-year-old woman was admitted to our hospital with unconsciousness. Glasgow Coma Scale was E1V3M5. We diagnosed her with acute meningitis due to S. pyogenes and started treatment using ceftriaxone. In spite of the improvement of her unconscious state, she developed a new-onset systolic murmur on day 13, and echocardiography revealed severe mitral valve regurgitation with vegetation. Therefore, we also diagnosed her with IE and continued the antibiotics for 6 weeks after we confirmed the negative blood cultures. The patient was finally transferred to another hospital for rehabilitation 57 days after admission. Considering that the number of S. pyogenes infections has been reported to increase in Japan and worldwide, we need to be more careful about the rare complication of meningitis and IE due to S. pyogenes.

  • valvar diseases
  • Infectious Diseases
  • meningitis
  • adult intensive care
  • stroke

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  • Contributors KI treated the patient and wrote this manuscript. AH and AK gave a helpful advice for the treatment of the patient. NO also contributed to the treatment and finally reviewed the manuscript.

  • Funding This work was supported in part by the Yokohama Rosai Hospital and National Center for Global Health and Medicine.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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