Olopoenia L A, Mody V, Reynolds M
Department of Medicine, Howard University Hospital, Washington, DC.
J Natl Med Assoc. 1994 Apr;86(4):313-5.
A rare case of Eikenella corrodens endocarditis in an intravenous drug user is reported. Repeated blood cultures from the patient established the diagnosis of this infection. However, evaluation of the cardiac function using two-dimensional echocardiography with Doppler flow demonstrated a large pedunculated tricuspid vegetation. Also evident on this study was a dilated right ventricle with diminished contractility and regurgitation. Complete sterilization of the blood was achieved after a 2-week course of intravenous penicillin and gentamicin followed by an additional 4-week course of intravenous penicillin alone. Clinicians treating suspected IV drug users should be aware of the potential pathogenicity of this rare, facultative, anaerobic gram-negative bacillus (E corrodens). A combination of intravenous penicillin and aminoglycoside should be considered as the initial treatment followed by an additional course of intravenous penicillin for such patients with valvular vegetation.
报告了一例静脉吸毒者发生的腐蚀埃肯菌心内膜炎罕见病例。对该患者反复进行血培养确定了此次感染的诊断。然而,使用二维超声心动图结合多普勒血流评估心脏功能显示,有一个巨大的带蒂三尖瓣赘生物。该检查还显示右心室扩大,收缩力减弱及反流。静脉注射青霉素和庆大霉素2周疗程,随后单独静脉注射青霉素4周疗程后,血液实现了完全杀菌。治疗疑似静脉吸毒者的临床医生应意识到这种罕见的兼性厌氧革兰氏阴性杆菌(腐蚀埃肯菌)的潜在致病性。对于有瓣膜赘生物的此类患者,应考虑将静脉注射青霉素和氨基糖苷类药物联合作为初始治疗,随后再进行一个静脉注射青霉素疗程。