Ronald A R, Pattullo A L
Department of Infectious Diseases and Medical Microbiology, Health Sciences Center Hospital, Winnipeg, Manitoba.
Can J Infect Dis. 1990 Winter;1(4):143-5. doi: 10.1155/1990/698410.
A case of Enterococcus faecalis endocarditis followed endoscopic retrograde cholangiopancreatography and percutaneous extraction of a biliary calculus is reported. The most likely cause of endocarditis, though unproven, is the latter procedure, as the bile is often infected during biliary tract obstruction, and bacteremia is frequent during percutaneous manipulations. Initial therapy with vancomycin was unsuccessful in clearing the bacteremia, possibly due to vancomycin tolerance of the isolate and lack of an aminoglycoside in the initial regimen. Cure was obtained when therapy with ampicillin and gentamicin was undertaken.
报告了1例粪肠球菌性心内膜炎病例，该病例发生在内镜逆行胰胆管造影术及经皮胆管结石取出术后。尽管未经证实，但心内膜炎最可能的病因是后一种手术，因为在胆道梗阻期间胆汁常被感染，且经皮操作期间频繁发生菌血症。最初使用万古霉素治疗未能清除菌血症，这可能是由于分离株对万古霉素耐受且初始治疗方案中缺乏氨基糖苷类药物。采用氨苄西林和庆大霉素治疗后治愈。
