Mohiyiddeen Gadha, Brett Ian, Jude Edward
Department of Medicine and Department of Radiology, Tameside General Hospital, Lancashire, UK.
J Med Case Rep. 2008 May 4;2:143. doi: 10.1186/1752-1947-2-143.
Atopic dermatitis (AD) is a common condition in the United Kingdom with the prevalence varying from 21% in infants aged 0-6 months to 6.4% at the age of 16 years. Patients with AD experience high rates of colonization of their skin surfaces by Staphylococcus aureus (S. aureus). In severe AD there is a potential risk of staphylococcal bacteremia and invasive infection such as acute endocarditis.
We report a case of acute endocarditis with mitral valve destruction caused by S. aureus in a 30-year-old man with severe AD. The patient received intensive inpatient treatment with antibiotics and underwent successful mitral valve replacement and skin treatment for AD.
Patients with severe AD are at higher risk of staphylococcal bacteremia and endocarditis. Staphylococcal endocarditis has to be considered in the differential diagnosis of febrile illness in patients with uncontrolled atopic dermatitis.
特应性皮炎（AD）在英国是一种常见病症，患病率从0至6个月婴儿的21%到16岁时的6.4%不等。AD患者的皮肤表面被金黄色葡萄球菌（金葡菌）高度定植。在重度AD中，存在金葡菌菌血症和侵袭性感染（如急性心内膜炎）的潜在风险。
我们报告一例30岁重度AD男性患者因金葡菌导致二尖瓣破坏的急性心内膜炎病例。患者接受了强化住院抗生素治疗，并成功进行了二尖瓣置换术以及AD的皮肤治疗。
重度AD患者发生金葡菌菌血症和心内膜炎的风险更高。在未得到控制的特应性皮炎患者发热性疾病的鉴别诊断中，必须考虑葡萄球菌性心内膜炎。
