Dilmen Serkan, Kilic Sahhan, Torun Akin
Cardiology, Menemen Public Hospital, Izmir, TUR.
Department of Cardiology, Sultan Abdulhamid Training and Research Hospital, Istanbul, TUR.
Cureus. 2023 Sep 8;15(9):e44903. doi: 10.7759/cureus.44903. eCollection 2023 Sep.
is considered a rare pathogen in infective endocarditis (IE). is a Gram-positive facultative anaerobic bacterium found in the environment and human flora. It is part of the microbiota of the skin and nasal mucosa of humans and has been increasingly reported as the etiologic agent of community-acquired and nosocomial diseases. A 91-year-old female patient was admitted to our clinic with complaints of increased fatigue for a week. Transthoracic echocardiography revealed a labile, echogenic appearance on the mitral valve that may be consistent with infective endocarditis, causing mitral regurgitation. Transesophageal echocardiography (TEE) confirmed this finding on the same day. In three-dimensional (3D) TEE, there was an oval mass of 1.9 cm × 1.1 cm at the level of the P2 scallop of the posterior mitral leaflet, and 1.0 cm of mobile vegetation was observed on it. Three serial blood cultures from peripheral vessels identified . Antibiotic treatment of the patient was started with daptomycin 1 × 750 mg and meropenem 3 × 1 g. The cardiology team advised the patient to undergo early surgery, but the patient declined, and the case was followed up medically. On the 10th follow-up day, the patient had a speech disorder. Cerebral computed tomographic angiography showed an appearance compatible with a septic embolism in the left main cerebral artery. The patient's condition worsened throughout follow-ups, and she died on day 12. The purpose of presenting this case is to emphasize the importance of Corynebacterium species, which is a cause of rare native valve infectious endocarditis, and to show the difficulties in its treatment.
在感染性心内膜炎(IE)中被认为是一种罕见病原体。它是一种革兰氏阳性兼性厌氧菌,存在于环境和人体菌群中。它是人类皮肤和鼻粘膜微生物群的一部分,并且越来越多地被报道为社区获得性和医院感染性疾病的病原体。一名91岁女性患者因一周来疲劳加重而入住我院。经胸超声心动图显示二尖瓣上有不稳定的回声外观,可能与感染性心内膜炎一致,导致二尖瓣反流。经食管超声心动图(TEE)于同日证实了这一发现。在三维(3D)TEE中,二尖瓣后叶P2扇贝水平有一个1.9 cm×1.1 cm的椭圆形肿块,其上观察到1.0 cm的活动赘生物。从外周血管采集的三份连续血培养物鉴定出……。患者开始接受达托霉素1×750 mg和美罗培南3×1 g的抗生素治疗。心脏病学团队建议患者尽早手术,但患者拒绝,该病例进行医学随访。在随访第10天,患者出现言语障碍。脑部计算机断层血管造影显示左大脑中动脉有与脓毒性栓塞相符的表现。在整个随访过程中患者病情恶化,于第12天死亡。介绍该病例的目的是强调棒状杆菌属作为罕见的天然瓣膜感染性心内膜炎病因的重要性,并展示其治疗中的困难。