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美国首例心内膜炎和菌血症病例报告:病例报告

First Reported Case of Endocarditis and Bacteremia in the United States: A Case Report.

作者信息

Nosheen Hajra, Pitasari Josephine R, Almorsy Khaled, Ali Shagufta N

机构信息

Department of Internal Medicine, McLaren Health Care/Michigan State University, Flint, Michigan, USA.

Department of Infectious Disease, McLaren Health Care/Michigan State University, Flint, MI, USA.

出版信息

J Community Hosp Intern Med Perspect. 2025 Mar 7;15(2):76-80. doi: 10.55729/2000-9666.1469. eCollection 2025.

Abstract

INTRODUCTION

are Gram-positive bacilli found as normal flora in the oral, urogenital, and gastrointestinal tracts. causing endocarditis is extremely rare, with only one prior case of endocarditis reported in 2020 in Thailand. We present the first case ever reported in the United States.

CASE DESCRIPTION

We present a 58-year-old African American woman with multiple comorbidities, including end-stage renal disease, on hemodialysis who presented with altered mentation. On investigations, she had bacteremia, with echocardiography revealing mitral valve vegetation. She was treated with IV antibiotics followed by oral amoxicillin-clavulanic acid.

DISCUSSION

Our case highlights the diagnostic challenges posed by slow-growing organisms like in patients with comorbidities, especially on hemodialysis. Blood cultures and transesophageal echocardiography were critical in diagnosing this case. Advanced microbial diagnostic techniques are crucial in identifying the pathogen and the pathogen's susceptibility-guided treatment. This case highlights the importance of early recognition and tailored therapy for rare pathogens like .

摘要

引言

革兰氏阳性杆菌是口腔、泌尿生殖道和胃肠道的正常菌群。引起心内膜炎极为罕见,2020年在泰国仅报告过1例心内膜炎病例。我们报告美国首例此类病例。

病例描述

我们报告一名58岁的非裔美国女性,有多种合并症,包括终末期肾病,正在接受血液透析,出现精神状态改变。经检查,她有菌血症,超声心动图显示二尖瓣有赘生物。她先接受静脉抗生素治疗,随后口服阿莫西林 - 克拉维酸。

讨论

我们的病例凸显了在合并症患者中,尤其是接受血液透析的患者中,像[此处原文缺失具体细菌名称]这种生长缓慢的微生物所带来的诊断挑战。血培养和经食管超声心动图对诊断该病例至关重要。先进的微生物诊断技术对于识别病原体以及根据病原体敏感性进行治疗至关重要。该病例凸显了对像[此处原文缺失具体细菌名称]这样的罕见病原体进行早期识别和针对性治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0da7/12039335/43992ee843a2/jchim-15-02-076f1.jpg

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