# Embolic Stroke as a Complication of Streptococcus gordonii Prosthetic Valve Endocarditis in a Pacemaker Carrier: First Case From Lebanon

## TL;DR

A rare case of Streptococcus gordonii endocarditis causing stroke in a pacemaker patient is reported from Lebanon, highlighting the need for vigilance in diagnosing unusual infections.

## Contribution

This is the first reported case of Streptococcus gordonii endocarditis in Lebanon, expanding its geographical and epidemiological understanding.

## Key findings

- Streptococcus gordonii was identified as the causative agent of embolic stroke in a patient with a prosthetic valve and pacemaker.
- The case highlights the rarity of this organism as a cause of endocarditis, with only a dozen prior reports in the literature.
- The report emphasizes the importance of considering unusual pathogens in the differential diagnosis of endocarditis.

## Abstract

In this article, we report the case of a 57‐year‐old hypertensive man with a prosthetic valve and a pacemaker who presented after many hours of onset of left‐sided hemiplegia, left facial drop and dysarthria. Computed tomography of the brain revealed an ischemic stroke, and after an extensive workup the diagnosis of an embolic stroke induced by a Streptococcus gordonii endocarditis was established. This organism is considered to be a rare cause of endocarditis as only a dozen cases were previously reported in the literature. We describe the clinical interventions used, expose the diagnostic approach and challenges faced. To the best of our knowledge, this is the first Streptococcus gordonii‐associated endocarditis that is reported in Lebanon and, as such, it widens the geographical setting in which it had been reported and helps gain a better understanding of its epidemiology and strain resistance. Furthermore, it highlights the need to include in the differential diagnosis of endocarditis unusual causative and infectious agents, and as such, it urges clinicians to maintain vigilance towards them and take timely intervention against them in order to ameliorate patients' prognosis. We also provide updates in this article on recent research findings and prevention strategies that may be used in the future against infectious endocarditis.