Gaudiano Roberta, Trizzino Marcello, Torre Salvatore, Virruso Roberta, Fiorino Fabio, Argano Vincenzo, Cascio Antonio
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, 90127 Palermo, Italy.
Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy.
Antibiotics (Basel). 2023 Jul 25;12(8):1232. doi: 10.3390/antibiotics12081232.
is a rare pathogen in human infections, although its incidence may be underestimated due to its difficult isolation. We describe the first known case of infective endocarditis (IE), which involves the mitral valve alone, and the seventh IE worldwide. Case presentation: a 62-year-old male was admitted to our department with a five-month history of intermittent fever without responding to antibiotic treatment. His medical history included mitral valve prolapse, recent pleurisy, and lumbar epidural steroid injections due to lumbar degenerative disc disease. Pre-admission transesophageal echocardiography (TEE) showed mitral valve vegetation, and was isolated on blood cultures by MALDI-TOF VITEK MS. During hospitalization, intravenous (IV) therapy with ampicillin and ceftriaxone was initiated, and was identified by MALDI-TOF Bruker Biotyper on three blood culture sets. A second TEE revealed mitral valve regurgitation, which worsened due to infection progression. The patient underwent mitral valve replacement with a bioprosthetic valve and had an uncomplicated postoperative course; he was discharged after six weeks of IV ampicillin and ceftriaxone treatment.
是人类感染中的一种罕见病原体，尽管由于其分离困难，其发病率可能被低估。我们描述了首例已知的仅累及二尖瓣的感染性心内膜炎（IE）病例，也是全球第七例IE。病例介绍：一名62岁男性因间歇性发热5个月且抗生素治疗无效入院。他的病史包括二尖瓣脱垂、近期胸膜炎以及因腰椎退行性椎间盘疾病接受的腰椎硬膜外类固醇注射。入院前经食管超声心动图（TEE）显示二尖瓣赘生物，通过基质辅助激光解吸电离飞行时间质谱仪（MALDI-TOF VITEK MS）从血培养中分离出该病原体。住院期间，开始静脉注射氨苄西林和头孢曲松治疗，通过布鲁克MALDI-TOF微生物鉴定仪在三组血培养中鉴定出该病原体。第二次TEE显示二尖瓣反流，由于感染进展而加重。患者接受了生物人工瓣膜二尖瓣置换术，术后过程顺利；在静脉注射氨苄西林和头孢曲松治疗六周后出院。
