HSIAO-LIANG CHENGWEI-CHOU LINPO-YUAN SHIHCHI-HSIANG HUANGYEN-CHUN HSUJR-CHI YIEChen S.-Y.CHIH-PENG LIN2022-03-042022-03-0420130300-8126https://www.scopus.com/inward/record.uri?eid=2-s2.0-84873713279&doi=10.1007%2fs15010-012-0334-6&partnerID=40&md5=180457a42f82bb480d3e1ba3753b3cbchttps://scholars.lib.ntu.edu.tw/handle/123456789/596145We present a case of a patient with underlying protein S deficiency who suffered from infective endocarditis with a large anterior mitral leaflet (AML) mass of approximately 4.5 cm in length. Intraoperative transesophageal echocardiography (TEE) revealed the mass at the AML base and a rupture of the posterior mitral leaflet chordae tendinae. The vegetation's large size may have been caused by one or more of three factors: location, underlying disease, and the microorganism causing infection. Patients with protein S deficiency are prone to thromboembolic events during cardiac surgery. Infective endocarditis caused by Streptococcus agalactiae usually has a poor prognosis, and, thus, early surgery is recommended. ? 2012 Springer-Verlag.[SDGs]SDG3D dimer; furosemide; penicillin G; aged; article; bacterial endocarditis; blood culture; cardiomegaly; case report; chorda tendinea rupture; diabetes mellitus; drowsiness; erythema; female; fever; follow up; group B streptococcal infection; high risk patient; human; hypertension; infection control; intraoperative period; leukocytosis; lung congestion; mitral valve disease; mitral valve replacement; petechia; prognosis; protein blood level; protein S deficiency; septic shock; Streptococcus agalactiae; systemic inflammatory response syndrome; systolic heart murmur; tachypnea; thorax radiography; thrombocytopenia; transesophageal echocardiography; Aged, 80 and over; Echocardiography, Transesophageal; Endocarditis, Bacterial; Female; Humans; Mitral Valve Insufficiency; Protein S Deficiency; Streptococcal Infections; Treatment Outcomejournal article10.1007/s15010-012-0334-6230014892-s2.0-84873713279