Streptococcus pyogenes Endocarditis Associated With Varicella-Case Report and Review of the Literature

Patrizia Savoia; Ulrich Heininger; Michael Buettcher

doi:10.3389/fped.2019.00500

Streptococcus pyogenes Endocarditis Associated With Varicella-Case Report and Review of the Literature

Front Pediatr. 2019 Dec 4:7:500. doi: 10.3389/fped.2019.00500. eCollection 2019.

Authors

Patrizia Savoia¹, Ulrich Heininger², Michael Buettcher³

Affiliations

¹ Paediatric Intensive Care and Neonatology, Lucerne Children's Hospital, Cantonal Hospital Lucerne, Lucerne, Switzerland.
² Department of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland.
³ Paediatric Infectious Diseases, Lucerne Children's Hospital, Cantonal Hospital Lucerne, Lucerne, Switzerland.

Abstract

Infection with varicella zoster virus (VZV) is usually a benign and self-limiting disease. Serious complications by bacterial pathogens do occur, such as necrotising fasciitis (NF). One of the most important is Streptococcus pyogenes (or Group A Streptococcus, GAS), which colonizes epithelial surfaces, primarily of the throat and skin. In rare instances, varicella may also be associated with S. pyogenes endocarditis. Review of the literature reveals only 18 children with infective endocarditis (IE) caused by GAS since 1942. VZV as antecedent illness was found in five (28%). Fourteen (78%) had no pre-existing cardiac abnormalities. Death occurred in three (17%) children. Infective endocarditis with acute deterioration secondary to rupture of mitral valve chordae tendineae necessitating cardiac surgery has not been reported in the literature yet. We present this rare and instructive pediatric case and the results of a literature search on S. pyogenes endocarditis in children.

Keywords: Streptococcus pyogenes; infective endocarditis; mitral valve; necrotizing fasciitis; vaccination; varicella.

Publication types

Case Reports