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中华链球菌引起的感染性心内膜炎:一种罕见但致命的感染。

Infective Endocarditis Caused by Streptococcus sinensis: A Rare but Fatal Infection.

作者信息

Tabone Adami Nicholas, Farrugia James, Galdes Angel

机构信息

Internal Medicine, Mater Dei Hospital, L-Imsida, MLT.

Infectious Disease, Mater Dei Hospital, L-Imsida, MLT.

出版信息

Cureus. 2024 Sep 29;16(9):e70444. doi: 10.7759/cureus.70444. eCollection 2024 Sep.

DOI:10.7759/cureus.70444
PMID:39473652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11521197/
Abstract

We present a case concerning a 65-year-old, previously healthy gentleman who was found to have infective endocarditis after presenting with a four-month history of constitutional symptoms. Blood tests taken in the community showed elevated inflammatory markers and a deterioration in renal function, which prompted his referral for inpatient investigations. Blood cultures and a transesophageal echocardiogram subsequently confirmed native valve endocarditis affecting both the aortic and mitral valves. Infective endocarditis is common in an infectious disease physician's daily practice, but this particular case is notable since the causative agent, , is an extremely rare viridans group , which has been reported only sporadically in other European countries. The patient was started on appropriate anti-microbial treatment and was scheduled for surgery to replace both affected valves. He developed signs and symptoms of congestive heart failure after 10 days of anti-microbial treatment and underwent dual valve replacement surgery. Despite optimal anti-microbial therapy and multiorgan support in a cardiac intensive care unit, the patient passed away two weeks after surgery as a result of ventilator-associated pneumonia.

摘要

我们报告一例病例,患者为一名65岁、既往健康的男性,在出现为期四个月的全身症状后,被诊断为感染性心内膜炎。社区进行的血液检查显示炎症指标升高且肾功能恶化,这促使他被转诊至医院进行住院检查。随后,血培养和经食管超声心动图证实为自体瓣膜心内膜炎,累及主动脉瓣和二尖瓣。感染性心内膜炎在感染科医生的日常诊疗中较为常见,但该病例较为特殊,因为病原体——[此处原文缺失病原体名称]是一种极为罕见的草绿色链球菌,在其他欧洲国家仅有零星报道。患者开始接受适当的抗菌治疗,并计划进行手术置换两个受影响的瓣膜。抗菌治疗10天后,他出现了充血性心力衰竭的症状和体征,并接受了双瓣膜置换手术。尽管在心脏重症监护病房接受了最佳的抗菌治疗和多器官支持,但患者在术后两周因呼吸机相关性肺炎去世。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd0f/11521197/f5c3915f9c11/cureus-0016-00000070444-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd0f/11521197/9006281ce4ba/cureus-0016-00000070444-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd0f/11521197/f5c3915f9c11/cureus-0016-00000070444-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd0f/11521197/9006281ce4ba/cureus-0016-00000070444-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd0f/11521197/f5c3915f9c11/cureus-0016-00000070444-i02.jpg

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本文引用的文献

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Evaluating the Duke Criteria for infectious endocarditis in a single-center retrospective study.在单中心回顾性研究中评估杜克标准用于感染性心内膜炎。
Sci Rep. 2024 Aug 22;14(1):19524. doi: 10.1038/s41598-024-70196-x.
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Oral streptococci: modulators of health and disease.口腔链球菌:健康与疾病的调节剂。
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Fatal outcome of first case of in infective endocarditis in the Netherlands: a case report.荷兰首例感染性心内膜炎病例的致命结局:一例病例报告。
Eur Heart J Case Rep. 2020 Jan 25;4(1):1-4. doi: 10.1093/ehjcr/ytz237. eCollection 2020 Feb.
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The oral cavity as a natural reservoir for Streptococcus sinensis.口腔作为中华链球菌的天然储存库。
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Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.21世纪感染性心内膜炎的临床表现、病因及转归:国际心内膜炎协作组前瞻性队列研究
Arch Intern Med. 2009 Mar 9;169(5):463-73. doi: 10.1001/archinternmed.2008.603.
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Streptococcus sinensis: an emerging agent of infective endocarditis.中华链球菌:感染性心内膜炎的一种新兴病原体。
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Streptococcus sinensis endocarditis outside Hong Kong.香港以外地区的中华链球菌性心内膜炎
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Streptococcus sinensis may react with Lancefield group F antiserum.中华链球菌可能与兰斯菲尔德F群抗血清发生反应。
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