Campagne J, Guichard J F, Moulhade M C, Kawski H, Maurier F
Service de Médecine Interne, Hôpitaux Privés de Metz, site Belle-Isle, 2 Rue de Belle-Isle, 57000, Metz, France.
Département de Biologie, Hôpitaux Privés de Metz, site Robert Schumann, Rue du Champ Montoy, 57070, Vantoux, France.
IDCases. 2020 May 17;21:e00811. doi: 10.1016/j.idcr.2020.e00811. eCollection 2020.
Lactobacilli are commensal bacteria in the normal flora of the oral cavity, gastrointestinal and genital tract. However, few cases of lactobacilli-induced bacteremia or endocarditis have been reported, particularly in immunocompromised patients. We reported a rare case of a 57-year-old man with a endocarditis without immunodeficiency in his medical history. He received a dental scaling one year before. Clinical presentation included weight loss, heart murmur, ankle arthritis and splinter hemorrhage. Echocardiography showed a mitral prolapse and a 16 mm vegetation associated with a valvular perforation. All blood cultures were positive for . Antibacterial regimen with amoxicillin and gentamicin led to recovery without surgery. We present a literature review of the lactobacillary endocarditis cases published since 1992. Valvulopathy, dental or invasive procedures and probiotics use were the main underlying conditions, in contrary to immunodeficiency. Diagnosis of lactobacillary endocarditis should be more considered and a treatment with penicillin and aminoglycoside should be promptly introduced in life-threatening cases.
乳酸杆菌是口腔、胃肠道和生殖道正常菌群中的共生细菌。然而，乳酸杆菌引起的菌血症或心内膜炎病例报道较少，尤其是在免疫功能低下的患者中。我们报告了一例罕见病例，一名57岁男性，病史中无免疫缺陷，却患有心内膜炎。他在一年前接受了洗牙治疗。临床表现包括体重减轻、心脏杂音、踝关节关节炎和瘀点出血。超声心动图显示二尖瓣脱垂以及一个与瓣膜穿孔相关的16毫米赘生物。所有血培养均为[此处原文缺失具体细菌名称]阳性。使用阿莫西林和庆大霉素的抗菌方案使患者未经手术而康复。我们对1992年以来发表的乳酸杆菌性心内膜炎病例进行了文献综述。与免疫缺陷相反，瓣膜病、牙科或侵入性操作以及益生菌的使用是主要的潜在病因。应更多考虑乳酸杆菌性心内膜炎的诊断，在危及生命的病例中应立即采用青霉素和氨基糖苷类药物进行治疗。
