Saeed Al-Asad Khalid, Mazhar Naveed, Srivastava Shaurya, Quadri Syed, Mitra Subhashis
Internal Medicine, Michigan State University, East Lansing, USA.
Infectious Disease, Michigan State University, East Lansing, USA.
Cureus. 2022 Oct 3;14(10):e29853. doi: 10.7759/cureus.29853. eCollection 2022 Oct.
A 75-year-old male, with a past medical history of chronic kidney disease stage 3 (CKD3) and a recent diagnosis of bilateral hydronephrosis and Foley catheter placement, presented to the emergency department for fever. Blood cultures grew Aerococcus urinae. Transthoracic echo (TTE) demonstrated thickened aortic valve leaflets with perforation, multiple echo densities, and severe aortic regurgitation. The patient developed decompensated congestive heart failure and cardiogenic shock. En route to surgery for emergent aortic valve replacement, the patient lost pulse and was resuscitated. The patient was subsequently transferred to the ICU where the family decided to initiate comfort care measures. This case highlights the importance and necessity of the prompt diagnosis and treatment of infective endocarditis and makes the reader aware of uncommon and rare organisms, such as Aerococcus urinae, as potential etiologies.
一名75岁男性,有慢性肾脏病3期(CKD3)病史,近期诊断为双侧肾盂积水并置入导尿管,因发热就诊于急诊科。血培养结果显示为尿液气球菌。经胸超声心动图(TTE)显示主动脉瓣叶增厚伴穿孔、多个回声密度影及严重主动脉瓣反流。患者出现失代偿性充血性心力衰竭和心源性休克。在前往急诊行主动脉瓣置换手术途中,患者脉搏消失,经抢救复苏。随后患者被转入重症监护病房,家属决定采取舒适护理措施。本病例强调了感染性心内膜炎及时诊断和治疗的重要性和必要性,并使读者了解到尿液气球菌等不常见和罕见微生物作为潜在病因的情况。