• Ruoxin Wang, Xuejie Cao, Fang Wu, Jinlong Zhao, Liang Fu, Ziming Yuan, Yinkai Ni, Zonghui Chen, and Feng Li.
• Department of Cardiovascular Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
• Medicine (Baltimore). 2022 Jul 8; 101 (27): e29360e29360.

IntroductionStreptococcus agalactiae is a common pathogen in infective endocarditis, but the positive rate of traditional blood culture diagnosis is not high. It is challenging to obtain a good outcome in the absence of pathogen information for patients with infectious endocarditis.Patient Concerns And DiagnosisHere, we report the case of a patient with infective endocarditis caused by S. agalactiae. The initial manifestations of this patient were coma, urinary incontinence, and fecal incontinence and had no history of heart disease or infectious diseases before admission.Interventions And OutcomesWhen the blood culture was negative 3 consecutive times, the pathogen S. agalactiae was diagnosed in a timely and accurate manner by metagenome sequencing. Eventually, the patient was discharged following surgery and antibiotic treatment.ConclusionsFor IE patients with infective endocarditis, metagenome sequencing is a valuable and selective tool for rapid, sensitive, and accurate pathogen detection, especially when the blood culture is negative.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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