Group G Streptococcus dysgalactiae subspecies equisimilis, the clinical significance of a rare infection: endocarditis, polyarteritis, septic bursitis and pneumonia with complicated parapneumonic effusion

Description

A man aged 55 years, a smoker, presented with a 7-day history of fever and additive oligoarthritis affecting both shoulders, left ankle (figure 1) and right fist. Group G Lancefield β-haemolytic Streptococcus dysgalactiae subspecies equisimilis (SDSE) was isolated from blood cultures; immunological study was not suggestive of autoimmunity and antistreptolysin O test was negative. In the first day after hospital admission, ischaemic lesions were seen on the fourth left finger (figure 2) and transoesophageal echocardiography was performed showing mitral valve vegetations and multiple jet mitral regurgitation. Multiple strokes affecting the spleen and right kidney were seen on the CT of the thorax, abdomen and pelvis, as well as multiple areas of lung consolidation with bilateral pleural effusion (a complicated exudate was documented after thoracentesis) and a fluid collection around the iliopsoas tendon (iliopectineal bursitis was confirmed by ultrasound-guided aspiration). We assumed SDSE bacteraemia...

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