Borcan Alina Maria, Olariu Mihaela Cristina, Costea Elena Liliana, Radu Georgiana, Simoiu Mădălina
MD, PhD, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, No. 8 Eroii Sanitari Boulevard, Bucharest, 050474, Romania, and Department of Microbiology, National Institute for Infectious Diseases "Prof. Dr. Matei Balş", No. 1 Dr. Calistrat Grozovici street, Bucharest, 021105, Romania.
MD, PhD, Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, No. 8 Eroii Sanitari Boulevard, Bucharest, 050474, Romania, and National Institute for Infectious Diseases "Prof. Dr. Matei Balş", No. 1 Dr. Calistrat Grozovici street, Bucharest, 021105, Romania.
Germs. 2024 Jun 30;14(2):210-215. doi: 10.18683/germs.2024.1433. eCollection 2024 Jun.
() is a commensal bacterial pathogen in the human oral cavity. It can, however, represent the source of local or systemic infections with serious evolution, in particular infective endocarditis. We present a particular case of an adult male patient with infective endocarditis with and patent ductus arteriosus (PDA).
A 37-year-old patient, chronic ethanol user, is hospitalized for altered general condition, persistent cough, left chest pain, headache and dizziness, symptoms evolving for about 3 weeks. The clinical examination revealed crackling pulmonary rales present basally bilaterally, as well as numerous cavities and dental abscesses. Chest radiography showed mixed left hiliobasal pneumonia. Chest CT depicted pulmonary abscess and two filling defects in the pulmonary artery trunk, possible thrombotic/vegetative images/mediastinal thrombotic/adenopathic images. Broad spectrum antibiotic treatment was initiated. Transthoracic ultrasonography visualized persistence of ductus arteriosus and an echodense formation attached to the lateral wall of the pulmonary artery trunk. Following positive blood cultures for , the diagnosis of infective endocarditis was established and antibiotic treatment was de-escalated to ceftriaxone according to the antibiogram. The clinical course under treatment was slowly favorable, the patient was discharged on request on day 44 with continued treatment at home.
Infective endocarditis caused by should be considered in patients with altered general condition and congenital cardiovascular defects. In the present case, the patient presented two risk factors, namely poor dental hygiene and PDA.
（）是人类口腔中的共生细菌病原体。然而，它可能是导致严重病情发展的局部或全身感染的源头，尤其是感染性心内膜炎。我们报告了一例成年男性感染性心内膜炎患者，该患者同时患有（）和动脉导管未闭（PDA）。
一名37岁的患者，长期酗酒，因全身状况改变、持续咳嗽、左胸痛、头痛和头晕入院，这些症状已持续约3周。临床检查发现双侧肺底部有湿啰音，还有多个空洞和牙脓肿。胸部X线显示左肺下叶基底段混合性肺炎。胸部CT显示肺脓肿以及肺动脉主干有两个充盈缺损，可能是血栓/赘生物影像/纵隔血栓/淋巴结影像。开始使用广谱抗生素治疗。经胸超声心动图显示动脉导管持续存在，并且在肺动脉主干侧壁附着有一个回声致密的结构。血培养结果为（）阳性后，确诊为感染性心内膜炎，并根据药敏结果将抗生素治疗降级为头孢曲松。治疗过程中临床症状逐渐好转，患者在第44天应要求出院，在家继续治疗。
对于全身状况改变且患有先天性心血管缺陷的患者，应考虑由（）引起的感染性心内膜炎。在本病例中，患者存在两个危险因素，即口腔卫生差和动脉导管未闭。
