PDF(Pubmed)
Abstract：
BACKGROUND: Staphylococcus aureus bacteraemia (SAB) is among the leading causes of bacteraemia and infectious endocarditis. The frequency of infectious endocarditis (IE) among SAB patients ranges from 5% to 10%-12%. In adults, the characteristics of epidermolytic hyperkeratosis (EHK) include hyperkeratosis, erosions, and blisters. Patients with inflammatory skin diseases and some diseases involving the epidermis tend to exhibit a disturbed skin barrier and tend to have poor cell-mediated immunity.
METHODS: We describe a case of SAB and infective endocarditis in a 43-year-old male who presented with fever of unknown origin and skin diseases. After genetic tests, the skin disease was diagnosed as EHK.
CONCLUSIONS: A breached skin barrier secondary to EHK, coupled with inadequate sanitation, likely provided the opportunity for bacterial seeding, leading to IE and deep-seated abscess or organ abscess. EHK may be associated with skin infection and multiple risk factors for extracutaneous infections. Patients with EHK should be treated early to minimize their consequences. If patients with EHK present with prolonged fever of unknown origin, IE and organ abscesses should be ruled out, including metastatic spreads.
METHODS: We describe a case of SAB and infective endocarditis in a 43-year-old male who presented with fever of unknown origin and skin diseases. After genetic tests, the skin disease was diagnosed as EHK.
CONCLUSIONS: A breached skin barrier secondary to EHK, coupled with inadequate sanitation, likely provided the opportunity for bacterial seeding, leading to IE and deep-seated abscess or organ abscess. EHK may be associated with skin infection and multiple risk factors for extracutaneous infections. Patients with EHK should be treated early to minimize their consequences. If patients with EHK present with prolonged fever of unknown origin, IE and organ abscesses should be ruled out, including metastatic spreads.
摘要：
背景：金黄色葡萄球菌菌血症（SAB）是菌血症和感染性心内膜炎的主要原因之一。SAB患者中感染性心内膜炎（IE）的发生率为5％至10％-12％。在成年人中,表皮松解性角化过度（EHK）的特征包括角化过度，侵蚀,和水泡。患有炎性皮肤病和一些涉及表皮的疾病的患者倾向于表现出受干扰的皮肤屏障并且倾向于具有差的细胞介导的免疫力。
方法：我们描述了一个43岁男性的SAB和感染性心内膜炎的病例，该病例表现为不明原因的发烧和皮肤病。经过基因测试,该皮肤病被诊断为EHK。
结论：继发于EHK的皮肤屏障破裂，加上卫生条件不足，可能为细菌接种提供了机会，导致IE和深部脓肿或器官脓肿。EHK可能与皮肤感染和皮肤外感染的多种危险因素有关。EHK患者应及早治疗，以尽量减少其后果。如果EHK患者出现不明原因的长期发烧，IE和器官脓肿应该排除，包括转移性扩散。
方法：我们描述了一个43岁男性的SAB和感染性心内膜炎的病例，该病例表现为不明原因的发烧和皮肤病。经过基因测试,该皮肤病被诊断为EHK。
结论：继发于EHK的皮肤屏障破裂，加上卫生条件不足，可能为细菌接种提供了机会，导致IE和深部脓肿或器官脓肿。EHK可能与皮肤感染和皮肤外感染的多种危险因素有关。EHK患者应及早治疗，以尽量减少其后果。如果EHK患者出现不明原因的长期发烧，IE和器官脓肿应该排除，包括转移性扩散。
