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由无乳链球菌引起的感染性原生心脏瓣膜心内膜炎:仅通过宏基因组测序技术进行病原体鉴定的病例报告。

Infectious native valve endocarditis by Streptococcus agalactiae species: Case report of pathogen identification only through metagenomic sequencing technology.

机构信息

Department of Cardiovascular Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.

Genoxor Medical Science and Technology Inc., Shanghai, China.

出版信息

Medicine (Baltimore). 2022 Jul 8;101(27):e29360. doi: 10.1097/MD.0000000000029360.

Abstract

INTRODUCTION

Streptococcus agalactiae is a common pathogen in infective endocarditis, but the positive rate of traditional blood culture diagnosis is not high. It is challenging to obtain a good outcome in the absence of pathogen information for patients with infectious endocarditis.

PATIENT CONCERNS AND DIAGNOSIS

Here, we report the case of a patient with infective endocarditis caused by S. agalactiae. The initial manifestations of this patient were coma, urinary incontinence, and fecal incontinence and had no history of heart disease or infectious diseases before admission.

INTERVENTIONS AND OUTCOMES

When the blood culture was negative 3 consecutive times, the pathogen S. agalactiae was diagnosed in a timely and accurate manner by metagenome sequencing. Eventually, the patient was discharged following surgery and antibiotic treatment.

CONCLUSIONS

For IE patients with infective endocarditis, metagenome sequencing is a valuable and selective tool for rapid, sensitive, and accurate pathogen detection, especially when the blood culture is negative.

摘要

简介

无乳链球菌是感染性心内膜炎的常见病原体,但传统血培养诊断的阳性率不高。对于没有病原体信息的感染性心内膜炎患者,获得良好的治疗效果具有挑战性。

患者关注和诊断

我们在此报告一例由无乳链球菌引起的感染性心内膜炎患者。该患者的初始表现为昏迷、尿失禁和大便失禁,且在入院前无心脏病或传染病史。

干预措施和结果

当连续 3 次血培养均为阴性时,通过宏基因组测序及时准确地诊断出病原体无乳链球菌。最终,患者在手术后和抗生素治疗后出院。

结论

对于感染性心内膜炎的 IE 患者,宏基因组测序是一种有价值且有选择性的工具,可用于快速、敏感和准确地检测病原体,尤其是在血培养为阴性时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09af/9259169/13bb93efbcce/medi-101-e29360-g001.jpg

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