Saladi Lakshmi, Zeana Cosmina, Singh Manisha
Department of Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USA.
Case Rep Infect Dis. 2017;2017:4896186. doi: 10.1155/2017/4896186. Epub 2017 May 14.
species are fastidious bacteria that have been isolated from skin, dental, and respiratory tract infections and rarely have been implicated in serious infections like meningitis, endocarditis, and osteomyelitis. A 76-year-old woman presented to our hospital with fever, vomiting, and generalized weakness for 3 days. A transthoracic echocardiogram showed a mobile structure on anterior mitral valve leaflet measuring 0.9 cm suggestive of vegetation. Empiric therapy with vancomycin and piperacillin-tazobactam was started with clinical resolution of her symptoms. On day 6, the blood culture drawn at admission grew species. A transesophageal echocardiogram confirmed a 1.2 × 0.4 cm echo dense structure attached to the left ventricular side of the anterior mitral leaflet. The patient was discharged home after 10 days of inpatient antibiotic therapy and completed 4 weeks of IV ceftriaxone at home without any adverse events. She was reevaluated in the clinic after completion of treatment and repeat blood cultures remained negative. We report the first case of successful treatment of endocarditis due to species with once daily ceftriaxone.
该菌种是苛养菌,已从皮肤、牙科和呼吸道感染中分离出来,很少与脑膜炎、心内膜炎和骨髓炎等严重感染有关。一名76岁女性因发热、呕吐和全身乏力3天前来我院就诊。经胸超声心动图显示二尖瓣前叶有一个0.9厘米的活动结构,提示有赘生物。开始使用万古霉素和哌拉西林-他唑巴坦进行经验性治疗,患者症状临床缓解。第6天,入院时采集的血培养物培养出该菌种。经食管超声心动图证实,二尖瓣前叶左心室侧附着有一个1.2×0.4厘米的回声致密结构。患者在接受10天的住院抗生素治疗后出院,并在家中完成了4周的静脉注射头孢曲松治疗,未出现任何不良事件。治疗完成后在门诊进行复查,重复血培养结果仍为阴性。我们报告了首例因该菌种引起的心内膜炎采用每日一次头孢曲松成功治疗的病例。