Walizada Aneil S, Lozada Arianna, Rizwan Dania, Zaher Nathan
Internal Medicine, Hospital Corporation of America (HCA) Florida Westside Hospital, Plantation, USA.
Cureus. 2025 Jul 24;17(7):e88668. doi: 10.7759/cureus.88668. eCollection 2025 Jul.
, a rare member of the , , , , and (HACEK) group, is an uncommon cause of infective endocarditis (IE) in adults. Advances in molecular diagnostics, including polymerase chain reaction (PCR) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), have significantly improved its identification. We present the case of a 78-year-old immunocompromised woman who developed watershed territory cerebral infarctions in the setting of endocarditis. The patient initially presented with fever, altered mental status, and right-sided weakness and was later found to have bacteremia, as well as a 7 mm aortic valve vegetation. Due to high surgical risk, the patient was managed conservatively with long-term intravenous antibiotics. This case highlights how modern diagnostic tools facilitate early detection of atypical pathogens and allow for more timely non-surgical management in vulnerable populations.
作为嗜血杆菌属、放线杆菌属、心杆菌属、艾肯菌属和金氏杆菌属（HACEK）菌群中罕见的一员，是成人感染性心内膜炎（IE）的一种不常见病因。包括聚合酶链反应（PCR）和基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF MS）在内的分子诊断技术的进步，显著提高了对其的识别能力。我们报告一例78岁免疫功能低下的女性病例，该患者在患心内膜炎的情况下发生了分水岭区脑梗死。患者最初表现为发热、精神状态改变和右侧肢体无力，后来发现有菌血症以及一个7毫米的主动脉瓣赘生物。由于手术风险高，该患者接受了长期静脉抗生素保守治疗。本病例突出了现代诊断工具如何有助于早期发现非典型病原体，并允许对脆弱人群进行更及时的非手术治疗。
