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因缺陷嗜养菌引起的心内膜炎,一种与固定矫治器存在相关的生物膜相关感染:病例报告。

Endocarditis due to Abiotrophia defectiva, a biofilm-related infection associated with the presence of fixed braces: A case report.

作者信息

Birlutiu Victoria, Birlutiu Rares Mircea

机构信息

aFaculty of Medicine, Lucian Blaga University of Sibiu, Sibiu bAcademic Emergency Hospital Sibiu-Infectious Diseases Clinic cSpitalul Clinic de Ortopedie-Traumatologie si TBC osteoarticular "Foisor," Bucuresti, Romania.

出版信息

Medicine (Baltimore). 2017 Nov;96(46):e8756. doi: 10.1097/MD.0000000000008756.

Abstract

RATIONALE

Endocarditis with Abiotrophia defectiva represents 4.3% to 6% of all streptococcal endocarditis. The article presents diagnosis issues and the complexity of the treatment.

PATIENT CONCERNS

We present the case of a female white patient, aged 26 years, who developed infectious endocarditis caused by A defectiva, in the last trimester of pregnancy, a biofilm-related infection associated with the presence of fixed braces.

DIAGNOSES

The diagnosis of infectious endocarditis was confirmed by the cardiac ultrasound examination that revealed a voluminous vegetation on the mitral valve, and acute mitral regurgitation caused by chordae tendinae rupture, and also by isolating Abiotrophia defectiva from two positive blood cultures.

INTERVENTIONS

The decision to undergo surgical intervention was taken, and a mitral valve replacement was performed. Surgical intervention that was associated with board-spectrum antibiotic therapy.

OUTCOMES

A defectiva, remains a rare cause of infective endocarditis, with a reserved prognosis that is motivated by the extensive valvular lesions and the risk of embolism.

LESSONS

The use of antibiotics administered in association, in the management of infective endocarditis, is mandatory.

摘要

理论依据

缺陷乏养菌性心内膜炎占所有链球菌性心内膜炎的4.3%至6%。本文介绍了诊断问题及治疗的复杂性。

患者情况

我们报告一例26岁白人女性患者,在妊娠晚期发生了由缺陷乏养菌引起的感染性心内膜炎,这是一种与固定矫治器相关的生物膜感染。

诊断

心脏超声检查发现二尖瓣上有大量赘生物,腱索断裂导致急性二尖瓣反流,且两次血培养均分离出缺陷乏养菌,从而确诊为感染性心内膜炎。

干预措施

决定进行手术干预,并实施了二尖瓣置换术。手术干预联合广谱抗生素治疗。

结果

缺陷乏养菌仍然是感染性心内膜炎的罕见病因,预后不佳,原因是瓣膜病变广泛及有栓塞风险。

经验教训

在感染性心内膜炎的治疗中,联合使用抗生素是必不可少的。

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