Jump to comment:
- Page navigation anchor for RE: Group B streptococcal endocarditis following elective surgical abortionRE: Group B streptococcal endocarditis following elective surgical abortion
I read with great interest the case report by Billick and Gold, entitled “Group B streptococcal endocarditis following elective surgical abortion” [1]. I would like to contribute some important and relevant points to this report, which are based on my experience.
Show More
I encountered a similar case of Group B streptococcal (Streptococcus agalactiae) infective endocarditis (IE) that occurred 2 years after transcatheter aortic valve implantation (TAVI). The patient was an elderly woman who presented to our department with a 3-day history of high fever and a 1-week history of general malaise and diarrhea. Since severe bacterial sepsis of unknown focus was suspected, a broad-spectrum antibiotic was started, with a favorable response to the treatment. The patient had frequent episodes of watery diarrhea after hospitalization, but the diarrhea and her general condition improved within a few days. Gram-positive cocci from 2 blood cultures suggested IE. Transesophageal echocardiography revealed vegetation on the implanted valve, which confirmed the diagnosis. The patient underwent emergency aortic valve replacement and was discharged without complications.
IE caused by S. agalactiae is rare and progresses rapidly, leading to a severe, life-threatening condition. [2] Early cardiac surgery is generally required. Since S. agalactiae is an indigenous bacterium mainly colonizing the vagina and colon, it can behave as a pathogen after gynecological surgery, as seen in the case re...Competing Interests: None declared.References
- 1. Maxime Billick, Wayne L. Gold. Group B streptococcal endocarditis following elective surgical abortion. CMAJ 2019;191:E916-E918.
- 2. Ivanova-Georgieva R, Ruiz-Morales J, Garcia-Cabrera E, et al. Left-sided infective endocarditis caused by Streptococcus agalactiae: rare and serious. Eur J Clin Microbiol Infect Dis 2019;38:265-75.
- Page navigation anchor for RE: Group B streptococcal endocarditis following elective surgical abortionRE: Group B streptococcal endocarditis following elective surgical abortion
I realise this response is somewhat delayed, but the copy containing this article, managed its arrival within the last week. Today being the 17th October, 2019, with the journal issue of the 19th August, 2019 instance.
Show More
What an excellent article, but one must have concerns over the apparent litany of medical errors, eventually leading to the patient's tricuspid valve replacement, as a result of a delayed diagnosis?
If the medical lives of professionals involved resembles mine, one must take issue with the constant change within the health services, which are requiring of actions to be undertaken such as the constant introduction of computerisation systems, alternative payment arrangements etc etc etc etc. If it is not the health services, it is the medical licensing authorities, who believe it their duty to micro-manage each and every action but which only serves to encumber our lives with more interferences, taking us away from being able to concentrate on patient care. And if it's not the two aforesaid groupings, it is the medical associations, both provincial and national, a need to up date our skills continuously, CME requirements.
None of their actions, in interfering with patient care, reduce medical errors and only serve to highlight a self-fulfilling prophecy, producing inferior care from nurses and doctors, resulting in more complaints, increased litigation costs and deteriorating mental health of these professionals.
One understan...Competing Interests: None declared.