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一名58岁女性结肠镜检查后并发栓塞性中风的路邓葡萄球菌感染性心内膜炎

Staphylococcus lugdunensis Infectious Endocarditis Complicated by Embolic Stroke After Colonoscopy in a 58-Year-Old Female.

作者信息

Ahmed Rafsan, Alsaiqali Mahmoud, Gorantla Asher, Sivakumar Shruthi, Feinberg Michelle, Graham-Hill Suzette, Salciccioli Louis

机构信息

Department of Internal Medicine, State University of New York Downstate Medical Center, New York City, USA.

Department of Neurology, State University of New York Downstate Medical Center, New York City, USA.

出版信息

Cureus. 2022 Apr 28;14(4):e24572. doi: 10.7759/cureus.24572. eCollection 2022 Apr.

Abstract

There are a significant number of colonoscopies and esophagogastroduodenoscopies (EGDs) done in the United States every year and post-endoscopic infections are frequently seen. Data demonstrating causality between endoscopic procedures and infectious endocarditis (IE) or that antibiotic prophylaxis prior to endoscopic procedures protects against IE is still lacking. Here we have presented the case of a patient who underwent diagnostic colonoscopy as part of a malignancy workup and was later found to be septic with bacteremia and had IE. We hypothesized that the infection was most likely contracted during colonoscopy as a result of bacterial translocation from the perineal region to the bloodstream. This case report highlights the need for further studies investigating the efficacy of prophylactic antibiotics in reducing the risk of IE after colonoscopies.

摘要

在美国,每年都有大量的结肠镜检查和食管胃十二指肠镜检查(EGD),内镜检查后感染屡见不鲜。目前仍缺乏数据表明内镜检查与感染性心内膜炎(IE)之间存在因果关系,或者内镜检查前使用抗生素预防可预防IE。在此,我们报告了一例患者,该患者作为恶性肿瘤检查的一部分接受了诊断性结肠镜检查,后来被发现因菌血症而败血症,并患有IE。我们推测,感染很可能是在结肠镜检查期间因细菌从会阴区域转移到血液中而发生的。本病例报告强调了进一步研究预防性抗生素在降低结肠镜检查后IE风险方面疗效的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b1/9138394/5b5822d94c6d/cureus-0014-00000024572-i01.jpg

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