导致感染性心内膜炎伴脑梗死和蛛网膜下腔出血：一例报告
causing infective endocarditis with brain infarction and subarachnoid hemorrhage: a case report.
作者信息
Yang Miaojuan, Lin Yanxia, Peng Xin, Wu Jingsong, Hu Bo, He Yitao, Lu Jian
机构信息
Department of Neurology, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China.
The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China.
出版信息
Front Med (Lausanne). 2023 May 3;10:1117474. doi: 10.3389/fmed.2023.1117474. eCollection 2023.
INTRODUCTION
A rare pathogen of Infective Endocarditis (IE), the , has been known to trigger life-threatening complications. The case discussed here is of a teenager with brain infarction and subarachnoid hemorrhage caused by IE due to .
CASE REPORT
A 15-year-old girl with movement disorders involving the left limbs and intermittent fevers was admitted to the hospital. A head CT scan revealed cerebral infarction in the right basal ganglia and subarachnoid hemorrhage. Moreover, vegetation on the mitral valve were confirmed by echocardiography. The blood cultures were found to be positive for Gram-positive streptococcus and identified by Vitek mass spectrometry as . She was prescribed vancomycin antibacterial therapy and underwent a surgical mitral valve replacement.
CONCLUSION
This case is suggestive of the fact that is a rare but crucial pathogen of IE-associated stroke. Obtaining early blood cultures and using microbial mass spectrometry could help achieve an accurate diagnosis. Moreover, reasonable anti-infective medications and surgical interventions need to be combined to avoid and/or manage severe complications.
引言
已知一种感染性心内膜炎（IE）的罕见病原体可引发危及生命的并发症。此处讨论的病例是一名青少年，因该病原体导致感染性心内膜炎，进而引发脑梗死和蛛网膜下腔出血。
病例报告
一名15岁女孩因左肢运动障碍和间歇性发热入院。头部CT扫描显示右侧基底节区脑梗死和蛛网膜下腔出血。此外，超声心动图证实二尖瓣上有赘生物。血培养发现革兰氏阳性链球菌呈阳性，经Vitek质谱鉴定为该病原体。她接受了万古霉素抗菌治疗，并接受了二尖瓣置换手术。
结论
该病例表明，该病原体是感染性心内膜炎相关中风的一种罕见但关键的病原体。尽早进行血培养并使用微生物质谱有助于实现准确诊断。此外，需要联合合理的抗感染药物和手术干预措施，以避免和/或处理严重并发症。
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