Squire Gareth, Hetherington Simon
Department of Cardiology, Kettering General Hospital, Kettering, Northamptonshire, UK
Department of Cardiology, Kettering General Hospital, Kettering, Northamptonshire, UK.
BMJ Case Rep. 2020 Feb 9;13(2):e233783. doi: 10.1136/bcr-2019-233783.
A 76-year-old woman presented with a 6-week history of malaise, night sweats and recurrent fever. She had a background of dilated cardiomyopathy for which she had a cardiac resynchronisation device in situ. She had several hospital admissions across this time with differing diagnoses offered. She received multiple courses of antibiotics with short-term symptom resolution. Blood cultures grew Gram-negative rods and samples were sent to a specialist centre for subtype analysis. A transthoracic echocardiogram revealed thickening of the distal right ventricular lead. A transoesophageal echocardiogram demonstrated a clearer vegetation on this lead. It transpired that she had been scratched by her dog a fortnight before symptom onset. The causal bacterium was reported as , a bacterium that exists almost exclusively in the saliva and claws of dogs and cats. She received an extended course of antibiotics with eventual removal of the infected device.
一名76岁女性出现了6周的不适、盗汗和反复发热症状。她有扩张型心肌病病史,体内植入了心脏再同步化装置。在此期间,她因不同的诊断多次入院。她接受了多疗程抗生素治疗,症状短期内得到缓解。血培养长出革兰氏阴性杆菌,样本被送往专科中心进行亚型分析。经胸超声心动图显示右心室远端导线增厚。经食管超声心动图更清晰地显示了该导线上的赘生物。原来,症状出现前两周她被自己的狗抓伤了。致病细菌被报告为 ,这种细菌几乎只存在于狗和猫的唾液和爪子中。她接受了延长疗程的抗生素治疗,最终取出了感染的装置。