Department of Cardiovascular Anesthesia, San Camillo-Forlanini Hospital, Rome, Italy.
Minerva Anestesiol. 2012 Jun;78(6):729-32. Epub 2011 Apr 26.
Prosthetic valve endocarditis (PVE) is a serious complication with potential fatal consequences, classified as early or late PVE, depending on whether typical symptoms occur within or later than 12 months from surgery. The incidence of early PVE is under 1%, but it carries high morbidity and mortality rates. There are few reported cases in literature of PVE due to Corynebacterium Jeikeium even though it is present in normal skin flora particularly in hospitalized patients. Corynebacterium species are, in fact, recognized as uncommon agents of endocarditis and little is known regarding species-specific risk factors and the outcome in this kind of endocarditis. Described is an unusual case report of a 57-year-old man who had early aortic PVE due to Corynebacterium Jeikeium infection complicated by dehiscence of the prosthesis, complete atrio-ventricular block, perforation of the interventricular septum and septic shock. Prompt diagnosis, choice of daptomycin as antibiotic therapy although it has only been approved by the European Medicine Agency (EMEA) for right-sided endocarditis and timely open heart surgery, resulted in a successful outcome.
人工瓣膜心内膜炎(PVE)是一种严重的并发症,可能导致致命后果,可分为早期或晚期 PVE,这取决于典型症状是在手术后 12 个月内出现还是 12 个月后出现。早期 PVE 的发病率低于 1%,但它的发病率和死亡率很高。尽管 Corynebacterium Jeikeium 存在于正常皮肤菌群中,尤其是在住院患者中,但文献中很少有报道 Corynebacterium Jeikeium 引起的 PVE 病例。实际上,Corynebacterium 物种被认为是心内膜炎的罕见病原体,对于这种心内膜炎的特定物种风险因素和结局知之甚少。本文描述了一例罕见病例,一名 57 岁男性因 Corynebacterium Jeikeium 感染导致早期主动脉瓣 PVE,合并假体分离、完全性房室传导阻滞、室间隔穿孔和感染性休克。及时的诊断、选用达托霉素作为抗生素治疗(尽管它仅被欧洲药品管理局(EMEA)批准用于右侧心内膜炎)以及及时的心脏直视手术,取得了成功的结果。