Citation
Mohammad Sallehuddin, Hakimah and Zakariah, Siti Zulaikha and Inche Mat, Liyana Najwa and Wan Zukiman, Wan Zul Haikal Hafiz and Hoo, Fan Kee and Ming, Tan Wei
(2019)
A rare case of streptococcus mitis infective endocarditis complicated by heart failure in a lactating mother with recurrent breast engorgement.
Malaysian Family Physician, 14 (2).
pp. 36-38.
ISSN 1985-207X
Abstract
Infective endocarditis during breastfeeding is rare. To the best of the authors’ knowledge, this is the second recorded case of infective endocarditis in a lactating mother. It is known that women of child-bearing age are susceptible to infective endocarditis during pregnancy when the immune system is compromised. Nevertheless, past cases were also exposed to a systemic infection via milk infected by their infant's oral commensal. Streptococcus mitis (S.Mitis) endocarditis in pregnancy has also been reported, whereby a lady delivered via caesarean section and underwent mitral valve reconstruction and annuloplasty. S. mitis is considered a pioneer streptococci commensal in human oral mucosa, appearing as early as 1-3 days after delivery. As a child grows, their oral mucosa will be colonized by more viridans streptococci, including the teeth, oropharynx and nasopharynx. In a mother who breastfeeds, a crack in the nipple and breast engorgement can be predisposing factors for systemic infection stemming from an infant's oral commensal. Both cases of breastfeeding-related infective endocarditis caused by pioneer streptococcus viridans, S.mitis in our report and S.salivarius3 in the previous report, affected the left-sided valves.
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