Lainscak Mitja, Lejko-Zupanc Tatjana, Strumbelj Iztok, Gasparac Ivan, Mueller-Premru Manica, Pirs Mateja
General Hospital Murska Sobota, Murska Sobota, Slovenia.
J Heart Valve Dis. 2005 Jan;14(1):33-6.
Endocarditis due to Abiotrophia sp. is rare and often associated with negative blood cultures. The rates of treatment failure, infection relapse and mortality are higher than in endocarditis caused by other viridans streptococci.
A retrospective review of A. defectiva endocarditis in a patient with prosthetic aortic valve and in a patient with Marfan syndrome was performed.
A. defectiva, susceptible to penicillin (MIC 0.064 mg/l and 0.016 mg/l, respectively) was isolated from blood cultures of both patients. Treatment with penicillin and gentamicin was started in both patients. Since the first patient developed a macular rash and leukopenia, penicillin was substituted with ceftriaxone. Both patients responded well to antibiotic treatment, did not need prosthetic valve insertion or reinsertion, and were without any sequelae at one year follow up.
Standard treatment of bacterial endocarditis with penicillin and gentamicin was effective in both patients. In contrast to previous reports, the present patients had a favorable outcome on completion of treatment and at one-year follow up.
由营养缺陷菌属引起的心内膜炎较为罕见，且常伴有血培养阴性。其治疗失败、感染复发及死亡率均高于其他草绿色链球菌引起的心内膜炎。
对1例人工主动脉瓣患者和1例马凡综合征患者的缺陷营养缺陷菌心内膜炎进行回顾性分析。
从两名患者的血培养中均分离出对青霉素敏感的缺陷营养缺陷菌（MIC分别为0.064mg/L和0.016mg/L）。两名患者均开始使用青霉素和庆大霉素治疗。由于首例患者出现斑丘疹和白细胞减少，青霉素被头孢曲松替代。两名患者对抗生素治疗反应良好，无需植入或重新植入人工瓣膜，随访一年无任何后遗症。
青霉素和庆大霉素对细菌性心内膜炎的标准治疗对两名患者均有效。与先前的报道不同，目前这两名患者在完成治疗及随访一年时预后良好。
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