Silva Ana Sofia, Baptista Mariana, Soares Inês, Macedo Diogo, Neto Rita R
Internal Medicine, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, PRT.
Cureus. 2024 Aug 18;16(8):e67122. doi: 10.7759/cureus.67122. eCollection 2024 Aug.
Infective endocarditis is a severe infection affecting the inner lining of the heart chambers and valves, often preceded by bacteremia and frequently caused by organisms from the commensal oral flora, including . However, remains an uncommon causative agent. We present the case of a 68-year-old male with a history of dyslipidemia, severe aortic insufficiency, and mild mitral insufficiency who presented with a two-week history of fever without other symptoms. Blood cultures were positive for , and a transthoracic echocardiogram revealed multiple vegetations on the aortic valve and smaller vegetations on the mitral valve. Additionally, splenic embolization was detected. The patient was treated with benzylpenicillin and gentamicin, followed by aortic valve replacement surgery. This case highlights a previously immunocompetent patient who developed bacteremia and fulfilled the definitive criteria for infective endocarditis, characterized by severe aortic valve insufficiency and splenic embolization, caused by a commensal oral bacterium rarely reported in clinical cases. The severity of the infection necessitated surgical intervention, and the patient subsequently made a full recovery without major complications post-discharge.
感染性心内膜炎是一种严重感染,累及心腔和瓣膜的内膜,通常先有菌血症,且常由共生口腔菌群中的微生物引起,包括 。然而, 仍然是一种不常见的病原体。我们报告一例68岁男性病例,有血脂异常、严重主动脉瓣关闭不全和轻度二尖瓣关闭不全病史,出现发热两周,无其他症状。血培养 呈阳性,经胸超声心动图显示主动脉瓣上有多个赘生物,二尖瓣上有较小赘生物。此外,检测到脾栓塞。患者接受苄星青霉素和庆大霉素治疗,随后接受主动脉瓣置换手术。该病例突出了一名先前免疫功能正常的患者,其发生菌血症并符合感染性心内膜炎的确诊标准,特征为严重主动脉瓣关闭不全和脾栓塞,由临床病例中很少报道的共生口腔细菌引起。感染的严重程度需要手术干预,患者随后完全康复,出院后无重大并发症。