RT Journal Article SR Electronic T1 A complication of meningitis and infective endocarditis due to Streptococcus pyogenes JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr-2017-220847 DO 10.1136/bcr-2017-220847 VO 2017 A1 Kosuke Inoue A1 Akiyoshi Hagiwara A1 Akio Kimura A1 Norio Ohmagari YR 2017 UL http://casereports.bmj.com/content/2017/bcr-2017-220847.abstract AB 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.