Infective endocarditis caused by Streptococcus bovis complicated by a superior mesenteric artery mycotic aneurysm and systemic septic emboli in a patient with colon diverticulitis.

To date, Streptococcus bovis endocarditis complicated by a superior mesenteric artery mycotic aneurysm and systemic septic emboli in a patient with colon diverticulitis has never been reported. A 46-year-old man, with a history of colon diverticulitis identified by diagnostic colon fiberscope and with hypertension, presented with a 14-day history of intermittent fever. An echocardiogram revealed severe mitral regurgitation with two large floating vegetations attached to both mitral leaflets. A blood culture grew S. bovis. Abdominal pain and left leg weakness developed 10 days after admission. Computerized tomography identified a 5×3cm mycotic aneurysm, and angiography revealed a saccular aneurysm at the distal branch of the superior mesenteric artery. A duplex study revealed an intravascular mass at the left femoral artery bifurcation. The patient accordingly underwent surgical resection of the mycotic aneurysm, removal of the mycotic thrombi, and mitral valve replacement. The patient's recovery was unremarkable.