Pathology Queensland-Central Microbiology Laboratory, Queensland Health, Brisbane, Queensland, Australia
Royal Brisbane Clinical Unit, University of Queensland School of Medicine, Herston, Queensland, Australia.
BMJ Case Rep. 2024 Nov 4;17(11):e262383. doi: 10.1136/bcr-2024-262383.
Prosthetic pulmonary valve endocarditis is a rare but serious infective complication following correction of tetralogy of Fallot (ToF). We describe a probable zoonotic case of subspecies prosthetic pulmonary valve infective endocarditis in a young woman with corrected ToF with regular exposure to horses. The case was further complicated by acalculous cholecystitis, which was the initial presenting syndrome, requiring laparoscopic cholecystectomy. Microbiological analysis of blood cultures yielded growth of with whole genome sequencing confirming the subspecies identification of The patient underwent successful combined medical and surgical management incorporating a 6-week course of intravenous antibiotics and a re-do homograft pulmonary valve replacement followed by prolonged oral antibiotic therapy. Clinicians should be mindful of the increased risk of endocarditis in adult congenital heart disease and relevant bacteraemia detection should prompt thorough valvular assessment.
人造肺动脉瓣心内膜炎是法洛四联症（ToF）矫正术后一种罕见但严重的感染性并发症。我们描述了一例年轻女性矫正 ToF 后，因经常接触马而可能发生的动物源亚种人造肺动脉瓣感染性心内膜炎。该病例进一步并发胆石症，即最初的表现综合征，需要进行腹腔镜胆囊切除术。血液培养的微生物分析显示 生长，全基因组测序证实了 的亚种鉴定。患者接受了成功的联合药物和手术治疗，包括 6 周的静脉抗生素治疗和再次进行同种异体肺动脉瓣置换术，随后进行了长期的口服抗生素治疗。临床医生应意识到成人先天性心脏病患者心内膜炎的风险增加，相关菌血症的检测应提示彻底的瓣膜评估。
