A case of infective endocarditis along with a ruptured valve caused by Streptococcus agalactiae in an immunocompetent man.
A case of infective endocarditis along with a ruptured valve caused by Streptococcus agalactiae in an immunocompetent man.
复制标题
一种感染性心内膜炎的病例以及由链球菌在免疫能力的人中引起的瓣膜破裂。
DOI：
10.1016/j.idcr.2016.10.012
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发表时间：
2016
期刊：
影响因子：
1.5
通讯作者：
Naito T
中科院分区：
文献类型：
--
作者：
Suzuki K;Hirai Y;Morita F;Uehara Y;Oshima H;Mitsuhashi K;Amano A;Naito T
无乳链球菌(S.agalactiae)是新生儿和孕妇侵袭性疾病的主要原因，但最近也在未怀孕的成年人中观察到，特别是老年人或患有潜在慢性病的人。无乳链球菌也是感染性心内膜炎的罕见原因，大多数病例需要早期手术。我们报告一位先前健康的43岁男性患者，他经历了快速进行性培养阴性感染性心内膜炎合并主动脉瓣肥大和严重的主动脉瓣关闭不全，继而合并腰椎间盘炎。在他入院的当天进行了紧急的主动脉瓣置换术，发现一个先天性的二尖瓣被植物破裂。对切除的主动脉瓣标本进行16S核糖体RNA基因测序，结果表明病原菌为无乳链球菌。因此，在快速进行性感染性心内膜炎的病例中，无乳链球菌应被认为是一种潜在的致病菌，即使它发生在非妊娠免疫能力正常的成年人身上。
Streptococcus agalactiae (S. agalactiae) is a major cause of invasive disease in neonates and pregnant women, but has also recently been observed among non-pregnant adults, especially elderly persons or persons with underlying chronic disease. S. agalactiae is also a rare cause of infective endocarditis, and most cases require early surgery. We report the case of a 43-year-old previously healthy man who experienced rapid progressive culture-negative infective endocarditis with aortic valve vegetation and severe aortic regurgitation, which was complicated by lumbar spondylodiscitis. Emergency aortic valve replacement was performed on the day of his admission, which revealed a congenital bicuspid aortic valve was ruptured by the vegetation. The resected aortic valve specimen was submitted for 16S ribosomal RNA gene sequencing, which revealed that the pathogen was S. agalactiae. Therefore, S. agalactiae should be considered a potentially causative pathogen in cases of rapid progressive infective endocarditis, even if it occurs in a non-pregnant immunocompetent adult.