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主动脉夹层修复术后由巨大芬戈尔德菌引起的感染性心内膜炎:一例报告及数据评估

Infective endocarditis caused by Finegoldia magna following aortic dissection repair: a case report and data evaluation.

作者信息

Hussein Khetam, Savin Ziv, Shani Liran, Dickstein Yaakov, Geffen Yuval, Raz-Pasteur Ayelet

机构信息

Infectious Disease Unit, Rambam Health Care Campus, Haifa, Israel.

Department of Internal Medicine A, Rambam Health Care Campus, Haifa, Israel.

出版信息

Am J Case Rep. 2014 Dec 12;15:554-8. doi: 10.12659/AJCR.892057.

Abstract

BACKGROUND

Finegoldia magna (F. magna) is a rare pathogen causing infective endocarditis (IE). Only 7 cases are documented in the literature.

CASE REPORT

We report a case of infective endocarditis in a 45-year-old male due to F. magna 2 months after a Bentall procedure. He presented with fever, dyspnea, and chest pain. Aerobic and anaerobic blood samples were drawn before empirical antibiotic treatment was initiated. A transesophageal echocardiogram (TEE) demonstrated several findings involving the prosthetic valve, including a vegetation. The patient underwent a second aortic repair procedure. Tissue cultures obtained from 2 sources in the infected area during the operation were positive for F. magna. The antibiotic regimen was changed in accordance with susceptibility testing to piperacillin/tazobactam. Two weeks after the operation, the patient was released with a recommendation for antibiotic treatment for 8 weeks.

CONCLUSIONS

We report this case because F. magna in a rare pathogen causing endocarditis. This was a case of prosthetic valve F. magna IE in which the definitive diagnosis was based on tissue cultures following sterile blood cultures. Data evaluation of all F. magna IE reported cases illustrated that tissue cultures were the predominant microbiologic diagnostic tool used.

摘要

背景

大芬戈尔德菌(F. magna)是一种引起感染性心内膜炎(IE)的罕见病原体。文献中仅记载了7例病例。

病例报告

我们报告一例45岁男性在Bentall手术后2个月因大芬戈尔德菌感染发生感染性心内膜炎的病例。他表现为发热、呼吸困难和胸痛。在开始经验性抗生素治疗前采集了需氧和厌氧血样。经食管超声心动图(TEE)显示了包括赘生物在内的几个涉及人工瓣膜的结果。患者接受了第二次主动脉修复手术。手术期间从感染区域的2个来源获取的组织培养物大芬戈尔德菌呈阳性。根据药敏试验将抗生素方案改为哌拉西林/他唑巴坦。术后两周,患者出院,并建议进行8周的抗生素治疗。

结论

我们报告此病例是因为大芬戈尔德菌是一种引起心内膜炎的罕见病原体。这是一例人工瓣膜大芬戈尔德菌感染性心内膜炎病例,其明确诊断基于无菌血培养后的组织培养。对所有已报告的大芬戈尔德菌感染性心内膜炎病例的数据评估表明,组织培养是主要使用的微生物学诊断工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee41/4270072/4306232aa3e9/amjcaserep-15-554-g001.jpg

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