Azelmat Sanae, Baadi Tarik, Benaissa Elmostafa, Jaafari Abdelhamid, Chadli Mariama
Microbiology, Mohammed V Military Training Hospital, Mohammed V University, Rabat, MAR.
Anesthesia and Intensive Care, Mohammed V Military Training Hospital, Mohammed V University, Rabat, MAR.
Cureus. 2024 Jul 16;16(7):e64639. doi: 10.7759/cureus.64639. eCollection 2024 Jul.
Infective endocarditis (IE) is a rare but severe disease due to frequent and serious complications. Healthcare-associated cases often involve , while Gram-negative bacteria such as , though rare, pose severe challenges due to their resistance profiles. We report a case of a 68-year-old woman with a history of hypertension and mitral valve replacement 12 years ago, who was admitted to the intensive care unit (ICU) for management of non-traumatic, afebrile altered mental status due to intracerebral hemorrhage from anticoagulant overdose. His stay in the ICU revealed septic shock with multi-organ failure caused by carbapenemase (New Delhi metallo-β-lactamase (NDM))-producing complicated by IE on the prosthetic mitral valve. Despite treatment with meropenem, colistin, and tigecycline, the patient succumbed to septic shock after 15 days of therapy. This case highlights the importance of close surveillance of nosocomial infections and the need for prompt management strategies integrating medical and surgical approaches to reduce the high mortality associated with such infections.
感染性心内膜炎（IE）是一种罕见但严重的疾病，因其并发症频繁且严重。医疗保健相关病例常涉及[此处原文缺失相关内容]，而革兰氏阴性菌，如[此处原文缺失相关内容]，虽然罕见，但因其耐药性而带来严峻挑战。我们报告一例68岁女性病例，该患者有高血压病史，12年前行二尖瓣置换术，因抗凝药物过量导致脑出血、无发热性精神状态改变而入住重症监护病房（ICU）进行治疗。她在ICU期间出现了由产碳青霉烯酶（新德里金属β-内酰胺酶（NDM））的[此处原文缺失相关内容]引起的感染性休克和多器官功能衰竭，并合并人工二尖瓣感染性心内膜炎。尽管使用美罗培南、黏菌素和替加环素进行了治疗，但患者在治疗15天后死于感染性休克。该病例强调了密切监测医院感染的重要性，以及需要迅速采取综合医疗和外科方法的管理策略，以降低与此类感染相关的高死亡率。
