Group B Streptococcal Tricuspid Endocarditis: Case Report and Systematic Review.

Abstract

Infective Endocarditis (IE), the microbial infection of the endocardial surface, is categorized by anatomy, microbiology, and valve nativity. Infective endocarditis generally affects older adults, and more commonly presents as a Left-sided IE (LSIE) affecting the mitral or aortic valves. Right-sided IE (RSIE) typically affects younger patients with less pre-existing valvular disease. RSIE is also more commonly associated with intravenous drug use (IVDU) and intra-cardiac instrumentation, such as pacemakers or defibrillators. While Staphylococcus aureus is the most common microorganism responsible for both LSIE and RSIE, Streptococcos agalactiae, or Group B Streptococcus (GBS), accounts for a very small percentage of IE, and, in such instances, rates of tricuspid endocarditis are dramatically lower than LSIE. GBS endocarditis usually affects patients with particular comorbidites, such as diabetes mellitus (DM) and cirrhosis. We present a case of GBS tricuspid endocarditis in a female patient without the typical risk factors for GBS endocarditis. We also present a systematic review of case reports and case series of GBS tricuspid endocarditis highlighting the risk factors, presentation and clinical characteristics, as well as up-to-date outcomes, and mortality rates of GBS endocarditis, a potentially fatal disease entity.