Zubair Safiyah Noor, Kisana Soofia, Anneski Cynthia J, Ahmed Imtiaz, Minhas Sajjad Ashraf
Arizona State University Tempe Arizona USA.
Department of Infectious Disease Mountain Vista Medical Center Mesa Arizona USA.
J Am Coll Emerg Physicians Open. 2022 Oct 6;3(5):e12821. doi: 10.1002/emp2.12821. eCollection 2022 Oct.
The patient is an 82-year-old male with a past medical history of aortic valve replacement who presented to the emergency department after a fall. He developed atrial fibrillation with a rapid ventricular response and non-ST-segment-elevation myocardial infarction, leading to hospitalization. During hospital admission, the patient complained of midline thoracic back pain, and an extensive evaluation for this complaint revealed discitis and osteomyelitis with epidural abscess near the T7 and T8 vertebrae that did not result in neurological deficits and required no surgical intervention. A total of 2 blood cultures were reported positive for , and . A transesophageal echocardiogram showed a small vegetation on the aortic prosthetic valve with probable small vegetation on the mitral valve. He was prescribed ceftriaxone intravenously for 12 weeks, followed by amoxicillin 2 g orally twice a day for at least 12 months. is not commonly known to cause infective endocarditis, whereas , and have been reported to do so. One previous case of was reported to cause prosthetic valve endocarditis as a single infectious agent. To our knowledge, this is the first case report for as part of multimicrobial bacteremia leading to endocarditis, discitis, and osteomyelitis.
该患者为一名82岁男性，既往有主动脉瓣置换病史，跌倒后就诊于急诊科。他出现了伴快速心室反应的心房颤动和非ST段抬高型心肌梗死，遂住院治疗。住院期间，患者主诉胸背部中线疼痛，针对该主诉进行的全面评估发现T7和T8椎体附近存在椎间盘炎、骨髓炎及硬膜外脓肿，但未导致神经功能缺损，无需手术干预。共2次血培养报告显示 及 阳性。经食管超声心动图显示主动脉人工瓣膜上有一个小赘生物，二尖瓣上可能也有小赘生物。他接受了为期12周的静脉注射头孢曲松治疗，随后口服阿莫西林2克，每日两次，至少持续12个月。 通常不被认为会引起感染性心内膜炎，而 及 据报道可引起感染性心内膜炎。既往有一例 报告显示作为单一感染病原体可引起人工瓣膜心内膜炎。据我们所知，这是首例关于 作为导致心内膜炎、椎间盘炎和骨髓炎的多重微生物菌血症一部分的病例报告。
