Lampe A S, Schroijen M A, Smith S J
HagaZiekenhuis, Afd. Medische Microbiologie, Den Haag.
Ned Tijdschr Geneeskd. 2008 Apr 5;152(14):827-30.
A 72-year-old man, having had an artificial valve for almost 20 years now, presented with tiredness that had persisted for several weeks and reported weight loss of 5 kg. In more recent days he experienced fever and cold shivers, and an associated dry cough. Bearing in mind the potential for endocarditis, blood cultures were grown. In this, we identified a small, Gram-negative rod with a small, smooth, raised colony that grew slowly. We considered a micro-organism from the 'HACEK group', which is a group of micro-organisms including Haemophilus aphrophilus, Haemophilus paraphrophilus, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae and Aggregatibacter (formerly: Actinobacillus) actinomycetemcomitans. More careful observation revealed that the bacteria formed star-shaped colonies, proving that A. actinomycetemcomitans was the cause of this non-acute endocarditis. The patient received antibiotic treatment. Because non-acute endocarditis is often caused by hidden abnormalities in the mouth or teeth and A. actinomycetemcomitans plays an important role in severe cases of peridontitis, a dental surgeon was consulted. The dental surgeon diagnosed multifocal peridontitis and treated the patient, who was able to leave the hospital after 6 weeks of antibiotic treatment.
一名72岁男性，使用人工瓣膜已近20年，出现持续数周的疲劳感，并报告体重减轻了5千克。最近几天，他出现发热和寒战，并伴有干咳。考虑到存在心内膜炎的可能性，进行了血培养。在培养物中，我们鉴定出一种革兰氏阴性小杆菌，其菌落小、光滑、凸起且生长缓慢。我们考虑是来自“HACEK菌群”的微生物，该菌群包括嗜沫嗜血杆菌、副嗜沫嗜血杆菌、人心杆菌、腐蚀艾肯菌、金氏金氏杆菌和伴放线聚集杆菌（以前称为：伴放线放线杆菌）。更仔细的观察发现，这些细菌形成星形菌落，证明伴放线聚集杆菌是这种非急性心内膜炎的病因。患者接受了抗生素治疗。由于非急性心内膜炎通常由口腔或牙齿的隐匿性异常引起，且伴放线聚集杆菌在严重牙周炎病例中起重要作用，因此咨询了牙科医生。牙科医生诊断为多灶性牙周炎并对患者进行了治疗，患者在接受6周抗生素治疗后得以出院。
