Kawasaki Yu, Matsubara Kousaku, Ishihara Haruko, Nigami Hiroyuki, Iwata Aya, Kawaguchi Koji, Fukaya Takashi, Kawamura Yoshiaki, Kikuchi Ken
Department of Pediatrics, Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe 651-2273, Japan.
Department of Pediatrics, Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe 651-2273, Japan.
J Infect Chemother. 2014 May;20(5):317-9. doi: 10.1016/j.jiac.2013.10.013. Epub 2013 Dec 11.
We here present a 7-year-old girl with ventricular septum defect and ventriculoatrial communication, who developed infective endocarditis (IE) due to Corynebacterium propinquum in the tricuspid valve. The patient was admitted because of an 8-day history of fever. Transthoracic echocardiogram showed non-pedunculated vegetation on the septal leaflet of the tricuspid valve. Gram-positive coryneform bacteria grew from three consecutive sets of blood cultures taken on admission. C. propinquum was confirmed by 3 microbiological approaches; (i) biochemical testing using API Coryne panels, (ii) a sequence-based method using the 16S rRNA gene and partial rpoB sequencing, and (iii) matrix-assisted laser desorption ionization-time of flight mass spectrometry. The isolates were susceptible to a wide variety of β-lactams and vancomycin. The patient was successfully treated with antimicrobial agents without surgical intervention. There have only been available of clinical details of two adult cases of invasive C. propinquum infections; one of which was presented as IE, and the other was pleuritis in a patient with lung cancer. To the best of our knowledge, this is the first report to describe C. propinquum as a cause of IE as well as that of invasive infections in a pediatric population. Multiple methods that reliably differentiated related species helped us to establish this rare organism. Our report expanded the clinical spectrum of C. propinquum infections.
我们在此报告一名7岁患有室间隔缺损和心室心房交通的女孩,她因毗邻棒状杆菌感染三尖瓣而发生感染性心内膜炎(IE)。患者因发热8天入院。经胸超声心动图显示三尖瓣隔叶有非带蒂赘生物。入院时连续三套血培养均培养出革兰氏阳性棒状杆菌。通过三种微生物学方法确认了毗邻棒状杆菌;(i)使用API Coryne鉴定板进行生化检测,(ii)使用16S rRNA基因和部分rpoB测序的基于序列的方法,以及(iii)基质辅助激光解吸电离飞行时间质谱法。分离株对多种β-内酰胺类药物和万古霉素敏感。患者在未进行手术干预的情况下接受抗菌药物成功治疗。目前仅有两例成人侵袭性毗邻棒状杆菌感染的临床细节报道;其中一例表现为IE,另一例是一名肺癌患者的胸膜炎。据我们所知,这是第一份将毗邻棒状杆菌描述为儿科人群中IE以及侵袭性感染病因的报告。多种可靠区分相关物种的方法帮助我们确定了这种罕见病原体。我们的报告扩展了毗邻棒状杆菌感染的临床谱。