Thadepalli H, Francis C K
West J Med. 1978 Jan;128(1):1-5.
Gram stains and cultures of multiple extravascular sites showed the infecting organisms in 17 of 26 heroin addicts with endocarditis. In addition to routine blood cultures, the etiologic agent was cultured from Osler nodes and Janeway lesions in ten patients, subcutaneous abscesses in eight, pleural fluids in eight, joint aspirates in three, spinal fluids in three, pericardial fluids in two, muscle abscesses in two and endometrium in one patient. Gram-positive cocci were found in extravascular lesions in 11 of 12 patients with staphy-lococcal endocarditis and from as many as four different sites. In contrast, no Gram-positive cocci were seen in extravascular sites in any of eight patients with enterococcal endocarditis although six of them had peripheral lesions. Gram stain and culture of multiple extravascular sites appears to provide a valuable early clue to the nature of the etiologic agent in addict endocarditis.
对26例患有心内膜炎的海洛因成瘾者的多个血管外部位进行革兰氏染色和培养，在其中17例中发现了感染病原体。除了常规血培养外，还从10例患者的奥斯勒结节和詹韦损害、8例皮下脓肿、8例胸腔积液、3例关节穿刺液、3例脑脊液、2例心包积液、2例肌肉脓肿以及1例患者的子宫内膜中培养出了病原体。在12例患有葡萄球菌性心内膜炎的患者中，有11例在血管外病变中发现了革兰氏阳性球菌，且多达四个不同部位。相比之下，8例患有肠球菌性心内膜炎的患者中，尽管其中6例有外周病变，但在任何血管外部位均未发现革兰氏阳性球菌。对多个血管外部位进行革兰氏染色和培养似乎为成瘾者心内膜炎病原体的性质提供了有价值的早期线索。
