Tsai Wei-Chung, Hsieh Hsiao-Cheng, Su Ho-Ming, Lu Po-Liang, Lin Tsung-Hsien, Sheu Sheng-Hsiung, Lai Wen-Ter
Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan.
Kaohsiung J Med Sci. 2008 Sep;24(9):481-6. doi: 10.1016/S1607-551X(09)70005-1.
Infective endocarditis owing to Mycobacterium abscessus infection is rarely reported. Most cases of infective endocarditis caused by Mycobacterium abscessus are seen in patients after valve replacement. Although early surgical intervention is recommended and medical treatment with antibiotics according to the susceptibility to the pathogen, such as amikacin, imipenem, cefoxitin, quinolones and macrolides, are applied, the course of such endocarditis is usually subacute and often has fatal outcomes. The present case was a 29-year-old male patient who was an intravenous drug user who had recurrent endocarditis caused by Mycobacterium abscessus. Unusually, our reported case was infected on his native valve. However, we experienced recurrence despite antimicrobial therapy. For culture-negative endocarditis, physicians should consider the possibility of Mycobacterium abscessus infection and related treatment difficulties.
由脓肿分枝杆菌感染引起的感染性心内膜炎鲜有报道。大多数脓肿分枝杆菌引起的感染性心内膜炎病例见于瓣膜置换术后的患者。尽管建议早期进行手术干预,并根据病原体的药敏情况应用抗生素进行药物治疗,如阿米卡星、亚胺培南、头孢西丁、喹诺酮类和大环内酯类,但这种心内膜炎的病程通常为亚急性,且往往会导致致命后果。本病例为一名29岁男性患者,他是一名静脉吸毒者,患有由脓肿分枝杆菌引起的复发性心内膜炎。不同寻常的是,我们报告的病例是其自身瓣膜受到感染。然而,尽管进行了抗菌治疗,我们仍经历了复发。对于血培养阴性的心内膜炎,医生应考虑脓肿分枝杆菌感染的可能性及相关治疗困难。