Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
Heart Lung. 2012 Nov-Dec;41(6):610-2. doi: 10.1016/j.hrtlng.2012.05.002. Epub 2012 Jun 15.
Prosthetic valve endocarditis (PVE) may be classified clinically as early (<60 days) or late (>60 days) post-valve replacement PVE. The pathogens of early versus late PVE differ in type and virulence. Early PVE pathogens are virulent, for example, Pseudomonas aeruginosa and Staphylococcus aureus. Late PVE pathogens resemble those of subacute bacterial endocarditis and are due to relatively avirulent and noninvasive organisms, for example, viridans streptococci. Viridans streptococci vary in their invasiveness and abscess potential. Myocardial abscess and complete heart block are rare complications of late PVE due to viridans streptococci. We present an unusual case of Streptococcus mitis late aortic PVE complicated by aortic root abscess, myocardial abscess, and complete heart block.
人工瓣膜心内膜炎（PVE）可根据临床情况分为早期（<60 天）和晚期（>60 天）瓣膜置换术后 PVE。早期与晚期 PVE 的病原体在类型和毒力上有所不同。早期 PVE 的病原体毒力较强，例如铜绿假单胞菌和金黄色葡萄球菌。晚期 PVE 的病原体类似于亚急性细菌性心内膜炎，由相对不具毒力和非侵袭性的生物体引起，例如草绿色链球菌。草绿色链球菌的侵袭性和脓肿形成潜能存在差异。草绿色链球菌引起的晚期 PVE 很少引起心肌脓肿和完全性心脏传导阻滞等并发症。我们报告了 1 例罕见的米氏链球菌引起的晚期主动脉瓣 PVE，并发主动脉根部脓肿、心肌脓肿和完全性心脏传导阻滞。
