Huber-Schneider C, Gubler J, Knoblauch M
Medizinische Abteilung, Kreisspital Männedorf.
Schweiz Med Wochenschr. 1994 Dec 3;124(48):2173-80.
The clinical features of 5 patients with invasive disease due to nontoxigenic Corynebacterium diphtheriae are presented. 4 patients had proven left sided endocarditis, and one had probable endocarditis of the mitral valve. 4 patients were intravenous drug abusers, and one had a girl friend who was also an iv-drug abuser. Only one patient had antibodies against human immunodeficiency virus. 2 patients with endocarditis of the mitral or the aortic valve, and one patient with endocarditis of a prosthetic aortic valve, died of septic complications. All patients or their partners frequented the same community of drug abusers. Since the blood culture isolates shared common features for biotyping, resistance patterns and also for ribotyping in three tested patients, we assume that all patients were infected by the same clone of C. diphtheriae. Drug abusers may become a new reservoir for C. diphtheriae infection. Along with our patients, we present an overview of the 49 published cases of C. diphtheriae endocarditis.
本文报告了5例由无毒力白喉棒状杆菌引起的侵袭性疾病患者的临床特征。4例患者确诊为左侧心内膜炎，1例可能为二尖瓣心内膜炎。4例患者为静脉注射吸毒者，1例患者的女友也是静脉注射吸毒者。仅1例患者有抗人类免疫缺陷病毒抗体。2例二尖瓣或主动脉瓣心内膜炎患者及1例人工主动脉瓣心内膜炎患者死于败血症并发症。所有患者或其伴侣均频繁出入同一吸毒者群体。由于在3例受试患者中，血培养分离株在生物分型、耐药模式及核糖体分型方面具有共同特征，我们推测所有患者均感染了同一克隆的白喉棒状杆菌。吸毒者可能成为白喉棒状杆菌感染的新储存宿主。结合我们的患者，本文还概述了已发表的49例白喉棒状杆菌心内膜炎病例。
