PDF(Pubmed)
Abstract：
Streptococcus alactolyticus is a non-motile Gram-positive, catalase-negative cocci, a part of group D Streptococci. In the literature, S. alactolyticus is documented as a causative agent of infective endocarditis, demonstrated by blood cultures in only four other cases, representing an extremely rare circumstance. Here, we describe a case of infective endocarditis due to S. alactolyticus in a young patient known with a bicuspid aortic valve and associated with a sigmoid precancerous polyp. The patient was also known to have blood hypertension and type II diabetes. Symptoms at the debut appeared insidiously and were non-specific: fatigue, loss of appetite, weight loss, night sweats, and fever. They lasted for the entire period of the illness with transient improvement during the courses of antibiotics. He followed more antibiotic courses prescribed for various clinical diagnoses. Each round of antibiotic treatment transitorily alleviated the symptoms, which reappeared each time after the cessation. The correct diagnosis was made only about three months after the appearance of the first clinical manifestations. This was based on ultrasound criteria (presence of vegetation and lesions of aortic cusps) and microbiological criteria (isolation of S. alactolyticus in blood cultures). A course of six weeks of ceftriaxone was considered the opportune antibiotic therapy. Similar to all other cases described in the literature, our patient presented important damage to the valvular tissue and required cardiac surgery to re-establish the normal function of the valve. The surgery consisted of the excision of the severely affected natural aortic valve and her replacement with a mechanical prosthetic valve. Following medical and surgical treatment, the patient is completely healed and has a normal life. Our case is noteworthy because of the scarcity of the involvement of S. alactolyticus in the pathogeny of infective endocarditis. This is the fifth published case with this etiology, and an overview of all five cases is provided in the article.
摘要：
脂乳链球菌是一种非运动的革兰氏阳性，过氧化氢酶阴性球菌,D组链球菌的一部分。在文学中,有文献记载，美国无流菌是感染性心内膜炎的病原体，仅在其他四例病例中通过血液培养证明，代表了极其罕见的情况。这里,我们描述了一例年轻的患者，该患者因动脉粥样硬化链球菌引起的感染性心内膜炎，该患者已知患有二叶主动脉瓣，并伴有乙状结肠癌前息肉。该患者还已知患有血液高血压和II型糖尿病。首次亮相时的症状阴险地出现，并且是非特异性的：疲劳，食欲不振,减肥,盗汗,和发烧。它们持续了整个疾病期间，在抗生素疗程中短暂改善。他遵循了更多的抗生素疗程，用于各种临床诊断。每一轮抗生素治疗都暂时缓解了症状，每次停止后都会再次出现。在首次临床表现出现后仅约三个月就做出了正确的诊断。这是基于超声标准(植被的存在和主动脉瓣尖的病变)和微生物学标准(血液培养物中的白乳杆菌的分离)。为期六周的头孢曲松治疗被认为是合适的抗生素治疗。与文献中描述的所有其他情况类似，我们的患者出现了瓣膜组织的重要损伤,需要进行心脏手术以重建瓣膜的正常功能.手术包括切除严重受影响的天然主动脉瓣，并用机械人工瓣膜进行置换。经过内科和外科治疗,病人完全痊愈，生活正常。我们的病例值得注意，因为在感染性心内膜炎的病因中，鼻烟链球菌的参与很少。这是发表的第五例这种病因，本文提供了所有五个案例的概述。
