Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
J Int Med Res. 2023 Nov;51(11):3000605231213264. doi: 10.1177/03000605231213264.
is a Gram-negative bacillus typically associated with bacteremia in immunocompromised patients. Prosthetic valve endocarditis (PVE) is a serious complication of prosthetic valve surgery, with a high mortality rate if not treated promptly. We present a rare case of PVE caused by . A man in his mid-60s presented to the Emergency Department with a fever and showed elevated C-reactive protein concentrations. He had prosthetic mitral and aortic valve replacement surgery 15 years previously. Gram-negative rods were detected in a blood culture. These rods were identified as using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and confirmed by 16S rRNA sequencing. The patient was treated with gentamicin and imipenem, and underwent valve replacement surgery. was isolated in a left atrial appendage swab obtained during the surgery. Follow-up blood cultures were negative after treatment. However, after a cardiac arrest event, the patient's general condition deteriorated, and he died. To the best of our knowledge, this is the first case of PVE caused by in Korea and the second fatality to date. This case highlights the importance of considering as a potential cause of PVE, even in patients without known risk factors.
是一种革兰氏阴性杆菌，通常与免疫功能低下患者的菌血症有关。人工瓣膜心内膜炎（PVE）是人工瓣膜手术后的一种严重并发症，如果不及时治疗，死亡率很高。我们报告了一例由 引起的罕见 PVE 病例。一名 60 多岁的男性因发热和 C 反应蛋白浓度升高而到急诊科就诊。他在 15 年前接受了二尖瓣和主动脉瓣置换手术。血培养中检测到革兰氏阴性杆菌。这些杆菌通过基质辅助激光解吸电离飞行时间质谱法鉴定为 ，并通过 16S rRNA 测序得到确认。患者接受了庆大霉素和亚胺培南治疗，并进行了瓣膜置换手术。术中从左心耳拭子中分离出 。治疗后随访血培养均为阴性。然而，在发生心脏骤停事件后，患者的一般情况恶化，最终死亡。据我们所知，这是韩国首例由 引起的 PVE 病例，也是迄今为止第二例死亡病例。该病例强调了即使在无已知危险因素的患者中，也应考虑 将其作为 PVE 的潜在病因。
