Thota Geethika, Joseph Betsy, Shah Monarch, Redel Henry, Yeruva Karthik R, Patel Keval
Department of Internal Medicine Saint Peter's University Hospital, New Brunswick, NJ, USA.
Department of Internal Medicine, Division of Infectious Disease Saint Peter's University Hospital, New Brunswick, NJ, USA.
Brown J Hosp Med. 2023 Mar 31;2(2):73883. doi: 10.56305/001c.73883. eCollection 2023.
Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) that constitutes normal skin flora and is often read as a contaminant when isolated in blood cultures. In recent years S. lugdunensis has been increasingly recognized as a true pathogen causing a spectrum of infections from benign skin and soft tissue infections to bacteremia, bone and joint infections, and endocarditis. A significant role in the pathogenesis of infections is played by the ability of the organism to form biofilms that allow it to attach itself to foreign objects such as pacemakers, prosthetic valves, and orthopedic implants. The mortality rate in infective endocarditis caused by S. lugdunensis has been as high as 38.8 % making it as virulent as Staphylococcus aureus reported in the literature. It requires aggressive antibiotics and optimal source control, including surgical debridement and valve replacement if indicated. We present a case of S.lugdunensis infective endocarditis in a patient with an automatic implantable cardioverter defibrillator (AICD). The patient presented with lower back pain for three weeks and was found to have a right psoas abscess and S.lugdunensis bacteremia, with a vegetation on the right ventricular defibrillator wire requiring device explantation and prolonged antibiotic treatment.
路邓葡萄球菌是一种凝固酶阴性葡萄球菌（CoNS），它是正常皮肤菌群的组成部分，在血培养中分离出来时常常被视为污染物。近年来，路邓葡萄球菌越来越被认为是一种真正的病原体，可引起一系列感染，从良性皮肤和软组织感染到菌血症、骨和关节感染以及心内膜炎。该生物体形成生物膜的能力在感染的发病机制中起着重要作用，这种能力使其能够附着在诸如起搏器、人工瓣膜和骨科植入物等异物上。由路邓葡萄球菌引起的感染性心内膜炎的死亡率高达38.8%，使其与文献中报道的金黄色葡萄球菌一样具有毒性。它需要积极的抗生素治疗和最佳的源头控制，包括必要时进行手术清创和瓣膜置换。我们报告一例植入自动植入式心脏复律除颤器（AICD）的患者发生路邓葡萄球菌感染性心内膜炎的病例。该患者出现下背部疼痛三周，被发现患有右腰大肌脓肿和路邓葡萄球菌菌血症，右心室除颤器导线上有赘生物，需要取出装置并进行长期抗生素治疗。
