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Abstract：
Infective endocarditis is a condition associated with high morbidity and mortality, usually with univalvular involvement. We describe the case of a 76-year-old woman with triple-valve endocarditis due to Streptococcus gallolyticus, complicated by perivalvular suppurative lesions, acute heart failure and acute kidney injury. Unfortunately, the patient died despite antibiotic therapy and emergent surgery. This case highlights uncommon triple-valve involvement in the absence of risk factors, posing a diagnostic and therapeutic challenge.
CONCLUSIONS: Native triple-valve endocarditis is extremely rare, especially in the absence of predisposing conditions.Streptococcus gallolyticus has been associated with endocarditis as well colonic and hepatobiliary pathology, so gastrointestinal endoscopy is important as bacteraemia frequently precedes gastrointestinal symptoms, allowing prompt diagnosis.In multivalvular involvement, early surgery is often required, and timely recognition and treatment before complications develop may be decisive for prognosis.
CONCLUSIONS: Native triple-valve endocarditis is extremely rare, especially in the absence of predisposing conditions.Streptococcus gallolyticus has been associated with endocarditis as well colonic and hepatobiliary pathology, so gastrointestinal endoscopy is important as bacteraemia frequently precedes gastrointestinal symptoms, allowing prompt diagnosis.In multivalvular involvement, early surgery is often required, and timely recognition and treatment before complications develop may be decisive for prognosis.
摘要：
感染性心内膜炎是一种与高发病率和死亡率相关的疾病，通常有单瓣受累。我们描述了一名76岁的女性由于溶胆链球菌而患有三瓣膜性心内膜炎的情况，并发瓣膜周围化脓性病变，急性心力衰竭和急性肾损伤。不幸的是,尽管抗生素治疗和紧急手术，患者仍死亡。该病例突出了在没有危险因素的情况下罕见的三瓣膜受累，构成诊断和治疗挑战。
结论：原生三瓣心内膜炎极为罕见，尤其是在没有易感条件的情况下。溶胆链球菌与心内膜炎以及结肠和肝胆病理有关，所以胃肠内镜检查很重要，因为菌血症经常先于胃肠道症状，允许及时诊断。在多瓣膜受累中，通常需要早期手术，在并发症发生之前及时识别和治疗可能是预后的决定性因素。
结论：原生三瓣心内膜炎极为罕见，尤其是在没有易感条件的情况下。溶胆链球菌与心内膜炎以及结肠和肝胆病理有关，所以胃肠内镜检查很重要，因为菌血症经常先于胃肠道症状，允许及时诊断。在多瓣膜受累中，通常需要早期手术，在并发症发生之前及时识别和治疗可能是预后的决定性因素。
