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一例由耐β-内酰胺类药物引起的感染性心内膜炎病例

A Case of Infective Endocarditis Caused by Beta-Lactam Resistant .

作者信息

Ntoga Melina, Emmanouil Vasileios, Terzi Eirini, Petrakis Vasilios, Panagopoulos Periklis, Papazoglou Dimitrios

机构信息

Department of Infectious Diseases, Second University Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli, Greece.

Department of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupoli, Greece.

出版信息

Eur J Case Rep Intern Med. 2025 Apr 10;12(5):005367. doi: 10.12890/2025_005367. eCollection 2025.

DOI:10.12890/2025_005367
PMID:40352691
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12061226/
Abstract

BACKGROUND

is a rare cause of human infections, with limited reports of infective endocarditis (IE).

CASE REPORT

We present a case of a 68-year-old male with severe aortic stenosis who developed associated IE resistant to beta-lactams. Initial treatment with vancomycin and gentamicin led to temporary improvement, but the patient later developed complications, including splenic infarction and an aortic root abscess. Despite intensified antimicrobial therapy, he ultimately succumbed to multiorgan failure.

CONCLUSION

This case underscores the importance of early identification of resistant pathogens, appropriate antibiotic selection, and vigilant monitoring for complications. The rising incidence of beta-lactam resistance in streptococcal infections highlights the need for ongoing epidemiological surveillance and research to optimize treatment strategies.

LEARNING POINTS

is a rare but emerging cause of infective endocarditis that necessitates increased clinical awareness.

摘要

背景

是人类感染的罕见病因,关于感染性心内膜炎(IE)的报道有限。

病例报告

我们报告一例68岁男性,患有严重主动脉瓣狭窄,并发对β-内酰胺类耐药的IE。最初使用万古霉素和庆大霉素治疗取得了暂时改善,但患者后来出现了并发症,包括脾梗死和主动脉根部脓肿。尽管加强了抗菌治疗,他最终还是死于多器官功能衰竭。

结论

本病例强调了早期识别耐药病原体、选择合适抗生素以及密切监测并发症的重要性。链球菌感染中β-内酰胺耐药性的发病率不断上升,凸显了持续进行流行病学监测和研究以优化治疗策略的必要性。

学习要点

是感染性心内膜炎的一种罕见但新出现的病因,需要提高临床认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03cf/12061226/fd84c9442ebf/5367_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03cf/12061226/fd84c9442ebf/5367_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03cf/12061226/fd84c9442ebf/5367_Fig1.jpg

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本文引用的文献

1
Infective Endocarditis and Stroke in a Healthy Young Female.一名健康年轻女性的感染性心内膜炎与中风
JACC Case Rep. 2024 May 6;29(11):102355. doi: 10.1016/j.jaccas.2024.102355. eCollection 2024 Jun 5.
2
Infective Endocarditis of a Rare Etiology of Streptococcus alactolyticus: A Case Report and Literature Review.解乳糖链球菌罕见病因所致感染性心内膜炎:1例报告及文献复习
Cureus. 2024 Mar 31;16(3):e57332. doi: 10.7759/cureus.57332. eCollection 2024 Mar.
3
Case Report: as a Rare Pathogen of Mitral Endocarditis.病例报告:作为二尖瓣心内膜炎的一种罕见病原体。
Front Cardiovasc Med. 2021 Apr 29;8:648213. doi: 10.3389/fcvm.2021.648213. eCollection 2021.
4
Human disease caused by <em>Streptococcus alactolyticus</em>: a case report of native valve infective endocarditis and review of the literature.由无乳链球菌引起的人类疾病:一例原发性心脏瓣膜感染性心内膜炎病例报告及文献复习。
Monaldi Arch Chest Dis. 2020 Oct 16;90(4). doi: 10.4081/monaldi.2020.1428.
5
A Rare Case of Streptococcus alactolyticus Infective Endocarditis Complicated by Septic Emboli and Mycotic Left Middle Cerebral Artery Aneurysm.1例罕见的无乳链球菌感染性心内膜炎合并脓毒性栓子及霉菌性左大脑中动脉动脉瘤
Case Rep Infect Dis. 2016;2016:9081352. doi: 10.1155/2016/9081352. Epub 2016 Jul 21.
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Infective endocarditis.感染性心内膜炎。
Lancet. 2016 Feb 27;387(10021):882-93. doi: 10.1016/S0140-6736(15)00067-7. Epub 2015 Sep 1.