Giamarellou H, Antoniadou A, Kanavos K, Papaioannou C, Kanatakis S, Papadaki K
Athens University School of Medicine, 1st Department of Propedeutic Medicine, Laiko, General Hospital, Greece.
Eur J Clin Microbiol Infect Dis. 1995 Feb;14(2):126-30. doi: 10.1007/BF02111871.
Endocarditis is a rare manifestation of Yersinia enterocolitica infection. The case of a 45-year-old man who presented with high fever and in whom prosthetic valve Yersinia enterocolitica endocarditis was diagnosed is described. The patient was successfully treated with ceftriaxone plus tobramycin, as proved by negative cultures of the prosthesis removed at the end of therapy. Including the patient reported, only 12 cases of Yersinia enterocolitica endocarditis have been published to date, two of which describe prosthetic cardiac valve endocarditis. The clinical characteristics do not distinguish septicemia from involvement limited to the cardiac valves. Diagnosis, however, has been improved by progress in echocardiography. Prognosis is grave but can be ameliorated if appropriate antimicrobial agents are administered, i.e. the combination of a third-generation cephalosporin plus an aminoglycoside. Fluroquinolones may also constitute an attractive therapeutic alternative.
心内膜炎是小肠结肠炎耶尔森菌感染的一种罕见表现。本文描述了一名45岁男性患者，他因高热就诊，被诊断为人工瓣膜小肠结肠炎耶尔森菌心内膜炎。患者接受头孢曲松加妥布霉素治疗成功，治疗结束时取出的人工瓣膜培养结果为阴性证实了这一点。包括本文报道的患者在内，迄今为止仅发表了12例小肠结肠炎耶尔森菌心内膜炎病例，其中2例描述的是人工心脏瓣膜心内膜炎。其临床特征无法区分败血症与仅限于心脏瓣膜的感染。然而，超声心动图技术的进步改善了诊断。预后严重，但如果使用合适的抗菌药物，即第三代头孢菌素加氨基糖苷类药物联合使用，预后可能会改善。氟喹诺酮类药物也可能是一种有吸引力的治疗选择。
