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1例罕见的粪肠球菌菌血症致感染性心内膜炎和骨髓炎病例

A Rarely Reported Case of Enterococcus faecalis Bacteremia Causing Infective Endocarditis and Osteomyelitis.

作者信息

Devarakonda Pradeep Kumar, Dhulipala Vishal R, Karki Monika, Ayala-Rodriguez Cesar, Reddy Sarath

机构信息

Internal Medicine, The Brooklyn Hospital Center, Brooklyn, USA.

Internal Medicine, Brooklyn Hospital, Brooklyn, USA.

出版信息

Cureus. 2022 Feb 23;14(2):e22522. doi: 10.7759/cureus.22522. eCollection 2022 Feb.

Abstract

Infective endocarditis (IE) is an infection of the heart valves or endocardium, usually due to the spread of infection through the blood. It can cause a varied range of symptoms, from being asymptomatic to reduced heart function, valvular abnormalities, embolization, or death. Enterococci are usually present as normal gut flora but can also cause bacteremia, urinary tract infections, or IE, especially in the elderly population. The source of enterococcal spread in most of the cases is unidentifiable and sometimes associated with the genitourinary tract or damage to the gut mucosa due to trauma, malignancy, and infection, among others. Very few cases have been reported so far on ( ) endocarditis and even rarer for such cases complicated by osteomyelitis. Here, we describe the case of a 63-year-old male patient with a recent history of cardiac arrest, a percutaneous endoscopic gastrostomy tube placement, and endotracheal tube placement. He presented with back pain and was found to have osteomyelitis on magnetic resonance imaging and aortic valve vegetations on transthoracic echocardiography (TTE). His blood cultures were positive for . Repeat TTE showed growth in the vegetation, and the patient underwent bioprosthetic aortic valve replacement.

摘要

感染性心内膜炎(IE)是心脏瓣膜或心内膜的感染,通常是由于感染通过血液传播所致。它可引起一系列不同的症状,从无症状到心脏功能减退、瓣膜异常、栓塞或死亡。肠球菌通常作为正常肠道菌群存在,但也可引起菌血症、尿路感染或感染性心内膜炎,尤其是在老年人群中。在大多数情况下,肠球菌传播的来源不明,有时与泌尿生殖道或因创伤、恶性肿瘤和感染等导致的肠道黏膜损伤有关。迄今为止,关于( )心内膜炎的报道极少,而此类病例合并骨髓炎的情况更为罕见。在此,我们描述一例63岁男性患者,他近期有心脏骤停史、经皮内镜下胃造瘘管置入术及气管插管置入术。他出现背痛,磁共振成像检查发现有骨髓炎,经胸超声心动图(TTE)检查发现主动脉瓣有赘生物。他的血培养( )呈阳性。重复TTE检查显示赘生物增大,该患者接受了生物人工主动脉瓣置换术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a87c/8956490/83f010fc200c/cureus-0014-00000022522-i01.jpg

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