Goel Rohan, Sekar Baskar, Payne Mark N
Cardiff University, Cardiff, UK Ysbyty Gwynedd, Bangor, UK.
Ysbyty Gwynedd, Bangor, UK.
BMJ Case Rep. 2015 Nov 26;2015:bcr2015212447. doi: 10.1136/bcr-2015-212447.
Infective endocarditis (IE) is a life-threatening condition with adverse consequences and increased mortality, despite improvements in treatment options. Diagnosed patients usually require a prolonged course of antibiotics, with up to 40-50% requiring surgery during initial hospital admission. We report a case of a 42-year-old intravenous drug user who presented feeling generally unwell, with lethargy, rigours, confusion and a painful swollen right leg. He was subsequently diagnosed with Proteus mirabilis endocarditis (fulfilling modified Duke criteria for possible IE) and deep vein thrombosis (DVT). He was successfully treated with single antibiotic therapy without needing surgical intervention or requiring anticoagulation for his DVT. Proteus endocarditis is extremely uncommon, with a limited number of case reports available in the literature. This case illustrates how blood cultures are invaluable in the diagnosis of IE, especially that due to unusual microorganisms. Our case also highlights how single antibiotic therapy can be effective in treating Proteus endocarditis.
感染性心内膜炎（IE）是一种危及生命的疾病，尽管治疗选择有所改善，但仍会产生不良后果并增加死亡率。确诊患者通常需要长期使用抗生素，高达40%-50%的患者在初次住院期间需要手术治疗。我们报告一例42岁静脉吸毒者的病例，该患者就诊时感觉全身不适，伴有乏力、寒战、意识模糊和右下肢疼痛肿胀。随后他被诊断为奇异变形杆菌性心内膜炎（符合可能的IE的改良杜克标准）和深静脉血栓形成（DVT）。他通过单一抗生素治疗成功治愈，无需手术干预，也无需对其DVT进行抗凝治疗。变形杆菌性心内膜炎极为罕见，文献中仅有有限数量的病例报告。本病例说明了血培养在IE诊断中的重要价值，尤其是对于由不常见微生物引起的IE。我们的病例还强调了单一抗生素治疗在治疗变形杆菌性心内膜炎方面的有效性。
