Reviewer ’s report  
 
Title:  Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic 
aneurysms and massive splenic infarction: a case report  
 
Version: 0 Date: 04 Sep 2017 
 
Reviewer:  Amine  Benmassaoud  
 
Reviewer’s report:  
 
Review:  
 
Dr. Achilli et al. describe in this case report an interesting and unique complication of invasive 
Streptococcus Agalactiae (GBS) in a healthy man who presented with massive splenic infarct 
and right hepatic artery mycotic aneurysms.  
 
The authors present a dequately the evolution of the case, including its presentation, initial 
diagnosis, management, and hospital course. They also elaborate at length on certain aspects of 
invasive GBS disease including a review of infective endocarditis, splenic infarction, and 
mycotic aneurysms.  
 
Some aspects of the manuscript deserve more attention, including the following:  
 
Please condense the case presentation and the discussion. For the discussion, I would suggest 
focusing on the presentation, differential diagnosis, a nd management of hepatic artery mycotic 
aneurysms. The management of infective endocarditis is not novel, and is extensively published.  
 
Please change the abbreviation for Streptococcus Agalactiae to GBS, for Group B Streptococcus. 
The abbreviation SA ref ers more commonly to Staphylococcus Aureus.  
 
Please revise the use of the word "extended" in line 83. Did you mean "extensive"?  
 
Please revise the sentence formulation throughout the manuscript, but especially in the 
discussion (eg. Line133, 135 etc…).  
 
Please revise the liver segment denomination throughout the manuscript (eg. In Line 117, it 
should read "segment VIII" and not "VIII segment").  
 
Please revise the use of abbreviations throughout the manuscript (eg. Line 138).  
 
Please use the same abbreviat ions consistently (eg. "day" compared to "die" in Line80 and 90).   
 
Please revise the use of punctuation throughout the manuscript.  
 
Thank you for the opportunity to review this very interesting case report.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some lan guage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from t he publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any  other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please g ive details below.  
 
I declare I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review p olicy of the journal  
Reviewer ’s report  
 
Title:  Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic 
aneurysms and massive splenic infarction: a case report  
 
Version: 0 Date: 04 Sep 2017 
 
Reviewer:  Amine  Benmassaoud  
 
Reviewer’s report:  
 
Review:  
 
Dr. Achilli et al. describe in this case report an interesting and unique complication of invasive 
Streptococcus Agalactiae (GBS) in a healthy man who presented with massive splenic infarct 
and right hepatic artery mycotic aneurysms.  
 
The authors present a dequately the evolution of the case, including its presentation, initial 
diagnosis, management, and hospital course. They also elaborate at length on certain aspects of 
invasive GBS disease including a review of infective endocarditis, splenic infarction, and 
mycotic aneurysms.  
 
Some aspects of the manuscript deserve more attention, including the following:  
 
Please condense the case presentation and the discussion. For the discussion, I would suggest 
focusing on the presentation, differential diagnosis, a nd management of hepatic artery mycotic 
aneurysms. The management of infective endocarditis is not novel, and is extensively published.  
 
Please change the abbreviation for Streptococcus Agalactiae to GBS, for Group B Streptococcus. 
The abbreviation SA ref ers more commonly to Staphylococcus Aureus.  
 
Please revise the use of the word "extended" in line 83. Did you mean "extensive"?  
 
Please revise the sentence formulation throughout the manuscript, but especially in the 
discussion (eg. Line133, 135 etc…).  
 
Please revise the liver segment denomination throughout the manuscript (eg. In Line 117, it 
should read "segment VIII" and not "VIII segment").  
 
Please revise the use of abbreviations throughout the manuscript (eg. Line 138).  
 
Please use the same abbreviat ions consistently (eg. "day" compared to "die" in Line80 and 90).   
 
Please revise the use of punctuation throughout the manuscript.  
 
Thank you for the opportunity to review this very interesting case report.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some lan guage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from t he publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any  other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please g ive details below.  
 
I declare I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review p olicy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title:  Streptococcus agalactiae infective endocarditis complicated by multiple mycotic hepatic 
aneurysms and massive splenic infarction: a case report  
 
Version: 0 Date: 04 Sep 2017 
 
Reviewer:  Amine  Benmassaoud  
 
Reviewer’s report:  
 
Review:  
 
Dr. Achilli et al. describe in this case report an interesting and unique complication of invasive 
Streptococcus Agalactiae (GBS) in a healthy man who presented with massive splenic infarct 
and right hepatic artery mycotic aneurysms.  
 
The authors present a dequately the evolution of the case, including its presentation, initial 
diagnosis, management, and hospital course. They also elaborate at length on certain aspects of 
invasive GBS disease including a review of infective endocarditis, splenic infarction, and 
mycotic aneurysms.  
 
Some aspects of the manuscript deserve more attention, including the following:  
 
Please condense the case presentation and the discussion. For the discussion, I would suggest 
focusing on the presentation, differential diagnosis, a nd management of hepatic artery mycotic 
aneurysms. The management of infective endocarditis is not novel, and is extensively published.  
 
Please change the abbreviation for Streptococcus Agalactiae to GBS, for Group B Streptococcus. 
The abbreviation SA ref ers more commonly to Staphylococcus Aureus.  
 
Please revise the use of the word "extended" in line 83. Did you mean "extensive"?  
 
Please revise the sentence formulation throughout the manuscript, but especially in the 
discussion (eg. Line133, 135 etc…).  
 
Please revise the liver segment denomination throughout the manuscript (eg. In Line 117, it 
should read "segment VIII" and not "VIII segment").  
 
Please revise the use of abbreviations throughout the manuscript (eg. Line 138).  
 
Please use the same abbreviat ions consistently (eg. "day" compared to "die" in Line80 and 90).   
 
Please revise the use of punctuation throughout the manuscript.  
 
Thank you for the opportunity to review this very interesting case report.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some lan guage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from t he publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any  other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please g ive details below.  
 
I declare I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review p olicy of the journal  
assistant