Brook Itzhak
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.
Cardiology. 2002;98(1-2):1-5. doi: 10.1159/000064684.
This review describes the microbiology, diagnosis and management of endocarditis due to anaerobic bacteria. Anaerobic bacteria are an uncommon but important cause of endocarditis. Most cases of anaerobic endocarditis are caused by anaerobic cocci, Propionibacterium acnes and Bacteroides fragilis group. Predisposing factors and signs and symptoms of endocarditis caused by anaerobic bacteria are similar to those seen in endocarditis with facultative anaerobic bacteria with the following exceptions: the gastrointestinal tract was the most common source for B. fragilis group endocarditis, the head and neck were the most common origin for Fusobacterium and Bacteroides spp., and the head and neck and genitourinary tract were the most common source for peptostreptococci. Complications with anaerobic endocarditis include valvular destruction, multiple mycotic aneurysms, aortic-ring abscess, aortitis, cardiogenic shock, dysrhythmias and septic shock. The mortality rate for patients with anaerobes endocarditis is 21-43%. Treatment of endocarditis involving anaerobic bacteria includes the use of antibiotic therapy effective against these organisms.
本综述介绍了由厌氧菌引起的心内膜炎的微生物学、诊断及治疗。厌氧菌是心内膜炎的一种罕见但重要的病因。大多数厌氧菌心内膜炎病例由厌氧球菌、痤疮丙酸杆菌和脆弱拟杆菌群引起。厌氧菌引起的心内膜炎的易感因素、体征和症状与兼性厌氧菌引起的心内膜炎相似，但有以下例外情况：胃肠道是脆弱拟杆菌群心内膜炎最常见的来源，头颈部是具核梭杆菌和拟杆菌属心内膜炎最常见的起源部位，而头颈部和泌尿生殖道是消化链球菌心内膜炎最常见的来源。厌氧菌心内膜炎的并发症包括瓣膜破坏、多发性真菌性动脉瘤、主动脉环脓肿、主动脉炎、心源性休克、心律失常和感染性休克。厌氧菌心内膜炎患者的死亡率为21% - 43%。涉及厌氧菌的心内膜炎的治疗包括使用对这些微生物有效的抗生素疗法。
