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解乳糖链球菌罕见病因所致感染性心内膜炎:1例报告及文献复习

Infective Endocarditis of a Rare Etiology of Streptococcus alactolyticus: A Case Report and Literature Review.

作者信息

Gherlan George S, Chicos Aura C, Veja Ana M, Enyedi Mihaly

机构信息

Infectious Diseases, Universitatea de Medicina si Farmacie "Carol Davila", Bucharest, ROU.

Infectious Diseases, Spitalul Clinic de Boli Infectioase si Tropicale "Dr. Victor Babes", Bucharest, ROU.

出版信息

Cureus. 2024 Mar 31;16(3):e57332. doi: 10.7759/cureus.57332. eCollection 2024 Mar.

Abstract

is a non-motile Gram-positive, catalase-negative cocci, a part of group D . In the literature, is documented as a causative agent of infective endocarditis, demonstrated by blood cultures in only four other cases, representing an extremely rare circumstance. Here, we describe a case of infective endocarditis due to in a young patient known with a bicuspid aortic valve and associated with a sigmoid precancerous polyp. The patient was also known to have blood hypertension and type II diabetes. Symptoms at the debut appeared insidiously and were non-specific: fatigue, loss of appetite, weight loss, night sweats, and fever. They lasted for the entire period of the illness with transient improvement during the courses of antibiotics. He followed more antibiotic courses prescribed for various clinical diagnoses. Each round of antibiotic treatment transitorily alleviated the symptoms, which reappeared each time after the cessation. The correct diagnosis was made only about three months after the appearance of the first clinical manifestations. This was based on ultrasound criteria (presence of vegetation and lesions of aortic cusps) and microbiological criteria (isolation of in blood cultures). A course of six weeks of ceftriaxone was considered the opportune antibiotic therapy. Similar to all other cases described in the literature, our patient presented important damage to the valvular tissue and required cardiac surgery to re-establish the normal function of the valve. The surgery consisted of the excision of the severely affected natural aortic valve and her replacement with a mechanical prosthetic valve. Following medical and surgical treatment, the patient is completely healed and has a normal life. Our case is noteworthy because of the scarcity of the involvement of in the pathogeny of infective endocarditis. This is the fifth published case with this etiology, and an overview of all five cases is provided in the article.

摘要

是一种革兰氏阳性、触酶阴性的非运动性球菌,属于D组。在文献中,仅在其他4例病例的血培养中被记录为感染性心内膜炎的病原体,这是一种极其罕见的情况。在此,我们描述了一例年轻患者因感染性心内膜炎的病例,该患者已知患有二叶式主动脉瓣,并伴有乙状结肠癌前息肉。该患者还患有高血压和II型糖尿病。首发症状隐匿出现且不具特异性:疲劳、食欲不振、体重减轻、盗汗和发热。这些症状在整个病程中持续存在,在抗生素治疗期间有短暂改善。他因各种临床诊断接受了更多疗程的抗生素治疗。每一轮抗生素治疗都能暂时缓解症状,但每次停药后症状都会再次出现。直到首次临床表现出现约三个月后才做出正确诊断。这是基于超声标准(存在赘生物和主动脉瓣叶病变)和微生物学标准(血培养中分离出 )。六周的头孢曲松疗程被认为是合适的抗生素治疗方案。与文献中描述的所有其他病例相似,我们的患者瓣膜组织受到了严重损害,需要进行心脏手术以恢复瓣膜的正常功能。手术包括切除严重受损的天然主动脉瓣,并用机械人工瓣膜进行置换。经过药物和手术治疗,患者已完全康复,生活正常。我们的病例值得注意,因为 在感染性心内膜炎病因中的参与情况很少见。这是第五例发表的具有这种病因的病例,本文提供了所有五例病例的概述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bcc/11061664/e29eace49bff/cureus-0016-00000057332-i01.jpg

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