Streptococcus agalactiae Native Valve Endocarditis in a Woman with Adenomyosis-Associated Chronic Anemia: A Case Report

Elvikri, Zahroh; Kusumaningrum, Deby

doi:10.21608/mid.2025.380050.2743

	Streptococcus agalactiae Native Valve Endocarditis in a Woman with Adenomyosis-Associated Chronic Anemia: A Case Report
Microbes and Infectious Diseases
Articles in Press, Accepted Manuscript, Available Online from 12 May 2025
Document Type: Short Reports (case reports)
DOI: 10.21608/mid.2025.380050.2743
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Authors
Zahroh Elvikri ¹; Deby Kusumaningrum ²^{, 3}
¹Study program of Clinical Microbiology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Jl. Prof Dr Moestopo 47, Surabaya, Indonesia
²Department of Medical Microbiology, Faculty of Medicine Universitas Airlangga, Indonesia
³Dr. Soetomo General Academic Hospital, Jl. Prof Dr Moestopo 47, Surabaya, Indonesia
Abstract
Streptococcus agalactiae (Group B Streptococcus, GBS) commonly colonizes the female genitourinary tract but can cause invasive infections under certain conditions. We report a rare case of native valve infective endocarditis (IE) caused by GBS in a 45-year-old woman with longstanding adenomyosis. She presented with fever, exertional dyspnea, and abnormal vaginal spotting. Laboratory studies revealed severe anemia; echocardiography demonstrated vegetation on the aortic valve. Blood cultures collected prior to antibiotics grew S. agalactiae, sensitive to multiple antibiotics. Targeted therapy with ampicillin and ceftriaxone led to clinical improvement without surgical intervention. Chronic bleeding due to adenomyosis likely disrupted mucosal barriers, facilitating GBS entry into the bloodstream and subsequent endocardial infection. This case highlights that GBS can cause aggressive native valve endocarditis even without structural heart disease and underscores the importance of early blood cultures for diagnosis and management. Recognition of gynecologic conditions as potential risk factors for bacteremia is crucial for favorable outcomes.
Keywords
Group B Streptococcus; Infective Endocarditis; Bacteremia; Gynecologic comorbidity


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