Recurrent Acute Ischemic Stroke after Infective Endocarditis Caused by Streptococcus Constellatus: First Case Report and Analysis of the Case Series

Acute ischemic stroke (AIS) is highly prevalent in patients with infective endocarditis (IE) and associated with high rates of death and disability. IE presenting as an acute ischemic stroke, especially recurrent concurrence of acute anterior and posterior circulation infarct, has rarely been reported. Herein, we report a case study of a 60-year-old man with a history of aortic valve replacement and was under warfarin, presented with recurrent acute ischemic stroke which was found to have no vegetation secondary to infective endocarditis caused by Streptococcus constellatus as the embolic source. This is the first case report of recurrent ischemic stroke secondary to IE without vegetation caused by Streptococcus constellatus involving concurrence of acute anterior and posterior circulation. We also then systematically analyze the cases with IE initially presenting as AIS reported in the literature to establish possible demographic, clinical, laboratory patterns, and prognostic features of these cases.