Liu Dongyan, Bateman Thomas, Carr Elisabeth, Foster Paul
Department of Medicine, Greater Baltimore Medical Center, Towson, MD, USA;
Department of Medicine, Greater Baltimore Medical Center, Towson, MD, USA.
J Community Hosp Intern Med Perspect. 2016 Sep 7;6(4):32357. doi: 10.3402/jchimp.v6.32357. eCollection 2016.
An 87-year-old Caucasian woman with hypertension, diabetes mellitus type 2, and COPD was admitted with 1-week duration of back pain and weight gain. The physical examination revealed jugular venous distention, rales in the left lower lung field, and severe pitting edema over lower extremities. As workup for leukocytosis, blood cultures grew Gemella haemolysans. Subsequently, a transthoracic echocardiogram revealed vegetation on the non-coronary aortic leaflet and mild aortic stenosis. She was treated with ampicillin and gentamicin. After further investigation, the patient was diagnosed with plasma cell myeloma, the monoclonal lambda type. This is the first reported case of G. haemolysans endocarditis in a multiple myeloma patient.
一名87岁的白人女性,患有高血压、2型糖尿病和慢性阻塞性肺疾病(COPD),因背痛和体重增加1周入院。体格检查发现颈静脉怒张、左下肺野啰音以及下肢严重凹陷性水肿。作为白细胞增多症的检查,血培养结果显示溶血孪生球菌生长。随后,经胸超声心动图显示非冠状动脉瓣叶有赘生物以及轻度主动脉瓣狭窄。她接受了氨苄西林和庆大霉素治疗。经过进一步检查,患者被诊断为单克隆λ型浆细胞骨髓瘤。这是首例报道的多发性骨髓瘤患者发生溶血孪生球菌性心内膜炎的病例。