PDF(Pubmed)
Abstract：
Lactococcus garviae (L. garviae) is a gram-positive coccus belonging to the Streptococcaceae family. While primarily a pathogen in fish farms causing hemorrhagic sepsis, it can act as a rare opportunistic pathogen in humans. A 2021 case report by Bravo et al. documented less than 30 cases of infective endocarditis caused by L. garviae worldwide at that time [1]. This case report describes the 27th documented case globally and 7th documented case in the USA of L. garviae causing infective endocarditis of a prosthetic valve [1]. L. garviae is found in unpasteurized dairy products, raw fish, and meat (pork, beef, and poultry), but the route of human transmission remains unclear [3]. It seems to have a predilection for individuals with prosthetic valves, immunocompromised states, prior gastrointestinal surgery, gastrointestinal disorders (colon polyps and diverticulosis), and the use of acid-reducing medications [1-3]. Infective endocarditis is the most common systemic disease caused by L. garviae [1-4]. This report details the case of a 75-year-old male, with multiple comorbidities and risk factors for L. garviae infection who was admitted for \"symptomatic anemia\". High clinical suspicion, coupled with an inadequate hemoglobin response to transfusion, a normal anemia workup, and blood cultures positive for L. garviae, promoted a transesophageal echocardiogram (TEE). However, the results were negative. Consequently, an 18F-fluorodeoxyglucose positron emission tomography/computed tomography scan (18FDG PET/CT) was performed. The scan revealed increased uptake in the aortic valve replacement consistent with prosthetic valve endocarditis in the setting of Lactococcus garviae bacteremia.
摘要：
甘草乳球菌（L.garviae）是属于链球菌科的革兰氏阳性球菌。虽然主要是在养鱼场引起出血性败血症的病原体，它可以作为人类罕见的机会病原体。Bravo等人的2021年病例报告。当时全世界记录的由L.garviae引起的感染性心内膜炎不到30例[1]。本病例报告描述了全球记录的第27例病例和美国记录的第7例L.garviae引起人工瓣膜感染性心内膜炎的病例[1]。在未经巴氏杀菌的乳制品中发现了L.garviae，生鱼,和肉（猪肉，牛肉,和家禽)，但是人类传播的途径仍然不清楚[3]。似乎对有人工瓣膜的人有偏爱，免疫受损状态，之前的胃肠手术，胃肠道疾病（结肠息肉和憩室病），以及使用降酸药物[1-3]。感染性心内膜炎是由甘草引起的最常见的全身性疾病[1-4]。这份报告详述了一名75岁男性的案例,有多种合并症和危险因素，因“症状性贫血”入院。临床高度怀疑,再加上血红蛋白对输血的反应不足，正常的贫血检查,和血培养液呈阳性，促进经食管超声心动图（TEE）。然而,结果为阴性。因此,进行了18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18FDGPET/CT).扫描显示主动脉瓣置换术中的摄取增加，这与链球菌菌血症的情况下的人工瓣膜心内膜炎一致。
