Department of Respiration and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, No. 2, Anzhen Road, Chaoyang District, Beijing, 100029, P.R. China.
BMC Infect Dis. 2024 Nov 14;24(1):1301. doi: 10.1186/s12879-024-10157-x.
Staphylococcus aureus infective endocarditis (IE) in native valves is associated with high mortality rates and is prone to various complications, including embolic strokes, which often result in poor prognoses. Contezolid, a novel oxazolidinone antibiotic, exhibits superior therapeutic efficacy with a reduced risk of hematologic toxicity. However, there are currently no reports on the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) IE accompanied by cerebrovascular complications.
We reported a young female patient with MSSA IE accompanied by cerebrovascular complications. She was diagnosed through blood culture, transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and cranial imaging, but the therapy using piperacillin-tazobactam and vancomycin failed. Therefore, the combination therapy of cefazolin and linezolid was applied, and her body temperature gradually returned to normal, and the infection symptoms were controlled. However, the platelets (PLT) dropped to 114 × 10/L, so contezolid was used as an alternative therapy. Subsequently, the PLT returned to normal. The patient received contezolid therapy for 3 weeks and was free of adverse events during the 2 years of follow-up.
This was the first case of MSSA IE accompanied by cerebrovascular complications in a young woman, who was successfully treated with an antibiotic regimen containing contezolid, without the need for surgical intervention, demonstrating remarkable efficacy and safety.
金黄色葡萄球菌感染性心内膜炎（IE）在原生瓣膜中与高死亡率相关，并且容易发生各种并发症，包括栓塞性中风，这通常导致预后不良。新型恶唑烷酮类抗生素康替唑胺具有优越的治疗效果，且血液毒性风险降低。然而，目前尚无关于治疗耐甲氧西林金黄色葡萄球菌（MSSA）IE 合并脑血管并发症的报道。
我们报告了一例年轻女性 MSSA IE 合并脑血管并发症病例。通过血培养、经胸超声心动图（TTE）、经食管超声心动图（TEE）和颅成像进行诊断，但使用哌拉西林他唑巴坦和万古霉素的治疗失败。因此，应用头孢唑林和利奈唑胺联合治疗，患者体温逐渐恢复正常，感染症状得到控制。然而，血小板（PLT）降至 114×10/L，因此改用康替唑胺作为替代治疗。随后，PLT 恢复正常。患者接受康替唑胺治疗 3 周，在 2 年的随访期间无不良反应。
这是首例年轻女性 MSSA IE 合并脑血管并发症病例，成功应用包含康替唑胺的抗生素方案治疗，无需手术干预，疗效显著且安全。
