Jadhav Kartik Pandurang, Pai Praveen G
Department of Adult Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
J Cardiol Cases. 2019 Jul 26;20(4):129-131. doi: 10.1016/j.jccase.2019.07.001. eCollection 2019 Oct.
A 70-year-old male with a past history of coronary artery bypass grafting, presented with high-grade fever and rapidly progressive dyspnea for 3 days. He was febrile and a prominent diastolic murmur was noted in the aortic area. Transesophageal echocardiography showed severe aortic regurgitation with multiple mobile vegetations attached to both supra- and infravalvular surfaces of aortic valve. Blood cultures grew which was confirmed with identification and antibiotic susceptibility test testing and S16 RNA sequencing. The patient underwent aortic valve replacement with a bioprosthetic valve. Repeat blood culture was sterile. He was continued on vancomycin injections for a total period of six weeks. Vagococcus is a unique genus of Gram-positive, catalase-negative, facultatively anaerobic cocci that was identified in 1989. The only other documented case of vagococcal endocarditis involving mitral and aortic valves had a similar rapidly progressive presentation with extensive valvular damage. infection appears to have fulminant course with sudden deterioration requiring surgical intervention. <: The objective in publishing this case report is multipronged. First is the rarity of the human infection by vagococci. The difficulty in accurate diagnosis of vagococcus from other lactobacilli. Vagococcus infection appears to have fulminant course with complete destruction of the valve involved, when compared to other lactobacilli. Therefore early and accurate diagnosis with surgical valvular replacement is the best way to manage this condition.>.
一名70岁男性,有冠状动脉旁路移植术病史,出现高热和进行性加重的呼吸困难3天。他发热,在主动脉区可闻及明显的舒张期杂音。经食管超声心动图显示严重主动脉瓣反流,主动脉瓣瓣上和瓣下表面均附着多个活动的赘生物。血培养生长出……,经鉴定、抗生素敏感性试验和S16 RNA测序得以确认。患者接受了生物人工瓣膜主动脉瓣置换术。重复血培养无菌。他继续接受万古霉素注射,共六周。漫游球菌是1989年发现的革兰氏阳性、过氧化氢酶阴性、兼性厌氧球菌的独特属。另一例有记录的累及二尖瓣和主动脉瓣的漫游球菌性心内膜炎病例有类似的快速进展表现及广泛的瓣膜损害。感染似乎病程凶险,突然恶化需要手术干预。<: 发表本病例报告的目的是多方面的。首先是漫游球菌感染人类罕见。从其他乳酸杆菌中准确诊断漫游球菌存在困难。与其他乳酸杆菌相比,漫游球菌感染似乎病程凶险,累及的瓣膜会完全破坏。因此,早期准确诊断并进行手术瓣膜置换是治疗这种疾病的最佳方法。>