Tamura Miku, Shoji Mitsutaka, Fujita Ken, Nakamura Shohei, Takahashi Yurika, Suzuki Yurika, Asakura Mika, Kimizuka Shun, Sasaki Makiko, Sugawara Katsuya
Department of Pharmacy, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi city, Chiba prefecture, Japan.
J Med Case Rep. 2017 Nov 17;11(1):324. doi: 10.1186/s13256-017-1494-x.
The clinical characteristics of infective endocarditis include the presence of predisposing cardiac disease, a history of illegal drug use, and high morbidity in the elderly. Only a few cases of the disease after delivery have been reported in the literature. We describe here a first case of enterococcal postpartum infective endocarditis without underlying disease in Japan.
We report the case of a 31-year-old Japanese woman with postpartum infective endocarditis by Enterococcus faecalis. She had no significant medical history or any unusual social history. After emergency surgery for severe mitral regurgitation and antimicrobial treatment for 6 weeks, she was discharged from our hospital and is now being monitored at an out-patient clinic.
We encountered a case of Enterococcus faecalis infective endocarditis that occurred in the native valve of a postpartum healthy woman. Although the pathogenesis of this case remains unclear, it could be due to bacteremia arising from the administration of prophylactic broad-spectrum antibiotics used for cesarean section. Previous use of cefotiam and urinary catheter insertion may be risk factors for nosocomial enterococcal bacteremia in this case.
感染性心内膜炎的临床特征包括存在易患心脏病、有非法药物使用史以及在老年人中发病率较高。文献中仅报道了少数产后发生该病的病例。我们在此描述日本首例无基础疾病的肠球菌性产后感染性心内膜炎病例。
我们报告一例31岁日本女性因粪肠球菌引起产后感染性心内膜炎的病例。她没有重要的病史或任何特殊的社会史。在因严重二尖瓣反流进行急诊手术后并接受了6周的抗菌治疗后，她从我院出院，目前正在门诊接受监测。
我们遇到一例粪肠球菌感染性心内膜炎病例，发生在一名产后健康女性的天然瓣膜。尽管该病例的发病机制尚不清楚，但可能是由于剖宫产预防性使用广谱抗生素引起的菌血症所致。在此病例中，先前使用头孢替安和插入导尿管可能是医院内肠球菌菌血症的危险因素。
