Patel Sachi, Rowe Danielle A, Arulthasan Marutha
College of Medicine, American University of Antigua, Osbourn, ATG.
Internal Medicine, Richmond University Medical Center, New York, USA.
Cureus. 2024 Oct 18;16(10):e71797. doi: 10.7759/cureus.71797. eCollection 2024 Oct.
Methicillin-sensitive (MSSA) is a gram-positive, coagulase-positive coccus implicated in the pathogenesis of infective endocarditis (IE) due to intravenous drug use (IDU). The tricuspid valve is the most commonly affected valve; however, there is an increased incidence of mitral valve involvement. In this case report, we present a 41-year-old female with no known past medical history but a social history significant for IDU who presented with MSSA bacteremia, sepsis, and IE with vegetations on the mitral valve. This patient had no predisposing immunocompromising conditions; however, her repeated IDU history increased her risks for IE. This patient subsequently developed fatal complications of renal septic emboli. She was treated with broad-spectrum intravenous antibiotics, vancomycin, and ceftriaxone, which was de-escalated to nafcillin following blood culture sensitivity data results. She was ultimately transferred to another facility for surgical management of her condition. We write this case report to bring awareness to this rare but fatal condition and to highlight the presentation of mitral valve vegetations.
甲氧西林敏感（MSSA）是一种革兰氏阳性、凝固酶阳性球菌，与静脉吸毒（IDU）导致的感染性心内膜炎（IE）发病机制有关。三尖瓣是最常受累的瓣膜；然而，二尖瓣受累的发生率有所增加。在本病例报告中，我们介绍了一名41岁女性，既往无已知病史，但有静脉吸毒的社会史，她因MSSA菌血症、脓毒症和二尖瓣赘生物的感染性心内膜炎就诊。该患者无易患免疫功能低下疾病；然而，她反复静脉吸毒的病史增加了她患感染性心内膜炎的风险。该患者随后出现了肾脓毒性栓子的致命并发症。她接受了广谱静脉抗生素、万古霉素和头孢曲松治疗，根据血培养敏感性数据结果，抗生素降级为萘夫西林。她最终被转至另一机构接受病情的手术治疗。我们撰写本病例报告是为了提高对这种罕见但致命疾病的认识，并突出二尖瓣赘生物的表现。
