Yang Mei-Li, Chen Yen-Hsu, Chen Tun-Chieh, Lin Wei-Ru, Lin Chun-Yu, Lu Po-Liang
Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan.
BMC Infect Dis. 2006 Dec 29;6:179. doi: 10.1186/1471-2334-6-179.
There are few reports in the literature of invasive infection caused by Brevundimonas vesicularis in patients without immunosuppression or other predisposing factors. The choice of antimicrobial therapy for bacteremia caused by the pathogen requires more case experience to be determined.
The case of a 40-year-old previously healthy man with subacute endocarditis proposed to be contributed from an occult dental abscess is described. The infection was found to be caused by B. vesicularis on blood culture results. The patient recovered without sequelae after treatment with ceftriaxone followed by subsequent ciprofloxacin therapy owing to an allergic reaction to ceftriaxone and treatment failure with ampicillin/sulbactam.
To our knowledge, this is the first report of B. vesicularis as a cause of infective endocarditis. According to an overview of the literature and our experience, we suggest that third-generation cephalosporins, piperacillin/tazobactam, and ciprofloxacin are effective in treating invasive B. vesicularis infections, while the efficacy of ampicillin-sulbactam needs further evaluation.
在无免疫抑制或其他易感因素的患者中,文献报道由泡囊短波单胞菌引起的侵袭性感染较少。针对该病原体所致菌血症的抗菌治疗选择需要更多病例经验来确定。
描述了一例40岁既往健康男性患亚急性心内膜炎的病例,推测其病因是隐匿性牙脓肿。血培养结果显示感染由泡囊短波单胞菌引起。患者因对头孢曲松过敏且氨苄西林/舒巴坦治疗失败,在接受头孢曲松治疗后改用环丙沙星治疗,最终康复且无后遗症。
据我们所知,这是泡囊短波单胞菌作为感染性心内膜炎病因的首例报告。根据文献综述及我们的经验,我们建议第三代头孢菌素、哌拉西林/他唑巴坦和环丙沙星对治疗泡囊短波单胞菌侵袭性感染有效,而氨苄西林 - 舒巴坦的疗效有待进一步评估。