Key result
An antibiotic course for Streptococcus agalactiae infective endocarditis led to unexpected spontaneous healing of a ruptured mycotic posterior mitral aneurysm and resolution of severe mitral regurgitation.
Case Report (n=1)
A rare case of ruptured mycotic mitral valve aneurysm spontaneously healed after antibiotic therapy, with 3D TEE playing a key role in monitoring.
Unexpected healing of mycotic mitral aneurysm after antibiotics may permit conservative management in select cases; leaves open role of surgery.
Mycotic mitral valve aneurysm is an uncommon complication that rarely appears in isolated mitral valve endocarditis. The weakened aneurysmal wall may rupture, causing severe mitral regurgitation. In this situation surgery is essential. We present a case of a rare complicated mycotic posterior mitral aneurysm. After completing the antibiotic course for Streptococcus agalactiae infective endocarditis, an unexpected healing process within the aneurysm led to the virtual disappearance of the mitral regurgitation and remarkably changed the patient's clinical outcome. We emphasize the key role of three-dimensional transesophageal echocardiography, as it is becoming the reference imaging technique for infective endocarditis.
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Villar et al. (2021) conducted a case report in Ruptured mycotic aneurysm of the posterior mitral leaflet due to Streptococcus agalactiae infective endocarditis (n=1). Antibiotic course was evaluated on Healing of aneurysm and disappearance of mitral regurgitation. An antibiotic course for Streptococcus agalactiae infective endocarditis led to unexpected spontaneous healing of a ruptured mycotic posterior mitral aneurysm and resolution of severe mitral regurgitation.
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