1.Sudden death due to infective endocarditis caused by Streptococcus constellatus: A case report
Zamasry, M.S ; Hilmi, Z. ; Mohd Yusof, M.Y.P ; Razali, H.S.A. ; Nawawi, H. ; Mahmood, M.S
Tropical Biomedicine 2019;36(4):845-849
Infective endocarditis (IE) is a relatively uncommon disease, but has been
challenging to diagnose over the years. With the increasing incidence, variety of causative
agents and the resistance of microorganisms towards antibiotics, there is still an occurrence
of sudden death due to undiagnosed IE. The most common microorganism causing IE is
Staphylococcus aureus. However, there is increasing prevalence of other microorganisms
causing IE. This case report highlights a case of sudden death due to IE caused by a rare
pathogen, Streptococcus constellatus which belongs to the Streptococcus anginosus group
(Milleri group). A study noted the crude incidence of IE in 6 world regions ranged between 1.5
and 11.6 cases per 100,000 people. To date, there has been no previous report on sudden
death due to IE caused by Streptococcus constellatus in Malaysia, neither in the forensic nor
clinical setting. This case report underlined the characteristics and pathological features of
this microorganism. The increasing incidence and variety of causative organisms in IE are
important public health issues. It is vital for future studies to examine the risk factors of IE
related to Streptococcus constellatus, to enhance better understanding, insight and awareness
regarding the course of this disease. This in turn may facilitate preventive measures to avoid
morbidity and mortality from this condition.