A Rare Case of Disseminated Group G Streptococcus Bacteremia Complicated by Multi-Systemic Infections: Infective Endocarditis, Endophthalmitis, and Meningitis.

BACKGROUND Group G streptococcus (GGS), primarily Streptococcus dysgalactiae subsp. equisimilis, is a commensal organism found on the skin, oropharynx, and the gastrointestinal and female genital tracts, often associated with superficial infections such as pharyngitis and cellulitis. Recent epidemiological trends indicate an increase in invasive GGS infection. While isolated cases have been reported, to our knowledge, this is the first reported case involving the simultaneous occurrence of infective endocarditis, endogenous endophthalmitis, and meningitis caused by GGS. CASE REPORT A 53-year-old man with a history of the Bentall procedure presented with 2 days of fever, slightly decreased consciousness, and ocular symptoms. He subsequently developed bilateral endogenous endophthalmitis and bacterial meningitis, both of which were diagnosed promptly through ophthalmologic examination and cerebrospinal fluid analysis. Blood cultures identified GGS, and he was treated with ampicillin 2 g every 4 hours. Blood cultures became negative on hospital day 4, after which he completed 8 weeks of antibiotics. He underwent vitrectomy and intravitreal antibiotics, which led to visual recovery in his right eye. Despite an initial echocardiogram that did not detect vegetations, gallium scintigraphy revealed signs of prosthetic valve endocarditis. His condition improved, and he was discharged on hospital day 66. CONCLUSIONS This case underscores the potential for GGS to cause severe, multisystem invasive disease and highlights the importance of early recognition and comprehensive management. Further research is needed to better understand the epidemiology, develop diagnostic strategies, and prevent invasive GGS infections.