St James's Hospital, Dublin, Ireland.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221092283. doi: 10.1177/23247096221092283.
Risk factors for infective endocarditis (IE) include congenital heart defects, poor dentition, immunosuppression, or recent instrumentation. The occupational hazard of a dog bite, combined with bicuspid aortic valve (BAV) led to IE. 16S ribosomal DNA was able to pinpoint the causative organism. A healthy 33-year-old postman presented in profound heart failure and sepsis due to aortic regurgitation and an aortic root abscess. He underwent emergency aortic valve replacement and was found to have a BAV and anomalous right coronary artery. Blood cultures remained negative. 16S ribosomal DNA polymerase chain reaction (PCR) revealed the causative organism was . On review, he recalled receiving a dog bite followed by a febrile illness a few days later. Congenital BAVs may become infected by seemingly innocuous injuries. 16S rDNA PCR is a more sensitive and specific diagnostic test than culture. This case demonstrates its utility in providing appropriate antimicrobial management for IE.
感染性心内膜炎（IE）的危险因素包括先天性心脏病、牙齿不良、免疫抑制或近期器械操作。狗咬伤的职业危害，加上二叶式主动脉瓣（BAV）导致 IE。16S 核糖体 DNA 能够确定病原体。一位健康的 33 岁邮递员因主动脉瓣反流和主动脉根部脓肿导致严重心力衰竭和败血症就诊。他接受了紧急主动脉瓣置换术，发现有 BAV 和异常的右冠状动脉。血液培养仍为阴性。16S 核糖体 DNA 聚合酶链反应（PCR）显示病原体是 。回顾病史，他回忆起曾被狗咬伤，几天后出现发热。先天性 BAV 可能因看似无害的损伤而感染。16S rDNA PCR 是一种比培养更敏感和特异的诊断试验。本例证明了它在为 IE 提供适当的抗菌药物管理方面的实用性。
