嗜酸乳杆菌心内膜炎
[Lactobacillus acidophilus endocarditis].
作者信息
Penot J P, Lagrange P, Darodes N, Ploy M C, Violet T, Virot P, Mansour L, Bensaid J
机构信息
Service de Cardiologie, CHU Dupuytren, Limoges.
出版信息
Presse Med. 1998 Jun 13;27(21):1009-12.
BACKGROUND
Lactobacillus is a commensal germ found in the buccal cavity, the digestive tract and the vagina. Usually non-pathogenic except in case of dental caries, it can occasionally be the causal agent in severe endocarditis.
CASE REPORT
A 70-year-old woman developed endocarditis on an aortic valve bioprosthesis. Lactobacillus acidophilus was isolated from blood cultures of the valve after surgery.
COMMENTS
Forty-four cases of Lactobacillus endocarditis have been reported in the literature to date. Mortality is high (26%). The main difficulty in treatment is germ tolerance to penicillin and aminosides found in all cases. Cure requires high dose parenteral antibiotics and surgery in many cases (26%).
背景
乳酸杆菌是一种存在于口腔、消化道和阴道的共生菌。通常无致病性，除非引发龋齿，它偶尔也可能是严重心内膜炎的病原体。
病例报告
一名70岁女性在主动脉瓣生物假体上发生心内膜炎。术后从瓣膜的血培养中分离出嗜酸乳杆菌。
评论
迄今为止，文献中已报道44例乳酸杆菌性心内膜炎。死亡率很高（26%）。治疗的主要困难在于所有病例中均发现该菌对青霉素和氨基糖苷类药物耐受。在许多情况下（26%），治愈需要大剂量静脉注射抗生素和手术。
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