Infective endocarditis complicated with multiple cerebral embolism and hemorrhage caused by Streptococcus sinensis: a rare case report and literature review

The article describes a rare case of a 68-year-old Chinese man with infective endocarditis caused by Streptococcus sinensis complicated by cerebral infarction with hemorrhagic transformation. The patient presented with fever, aphasia, joint pain, and partial paralysis of the right side of the body. Initial cardiac ultrasound did not show vegetations, which were identified only after neurological stabilization. Antibiotic therapy was adjusted based on culture and susceptibility results. A combination of linezolid and cefazolin for 4 weeks led to patient stabilization. The patient declined heart surgery and was discharged with continued treatment of linezolid and moxifloxacin for another 4 weeks. The case demonstrates that infective endocarditis caused by S. sinensis can affect the central nervous system and early pathogen identification is crucial for better outcomes.