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Aortitis infecciosa causada por Corynebacterium striatum en un paciente con trasplante ortotópico de corazón en dos
Wei Xiang1, Ling-Yun Kong1, Peng Zou1
1Cardiovascular center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Litanglu 168, Tiantongyuan, Changping District, Beijing, 102218, China.
BMC infectious diseases
|August 20, 2025
Resumen
La aortitis infecciosa causada por Corynebacterium striatum es rara después del trasplante de corazón. El diagnóstico rápido y la terapia médica llevaron a una resolución exitosa de la infección y los embolios en este caso.
Área de la Ciencia:
- Cardiología
- Enfermedades infecciosas
- Medicina del trasplante
Sus antecedentes:
- La aortitis infecciosa (IA) con vegetación es una complicación rara en pacientes trasplantados de corazón (HTx).
- La IA causada por Corynebacterium striatum (C. striatum) es excepcionalmente poco frecuente.
- Este informe detalla un caso de IA debido a C. striatum en un paciente ocho meses después de la segunda HTx ortotópica.
Objetivo del estudio:
- Para reportar un caso raro de aortitis infecciosa causada por Corynebacterium striatum en un paciente trasplantado de corazón.
- Para enfatizar los desafíos de diagnóstico y el manejo exitoso de esta condición.
Principales métodos:
- Informe de caso de un joven después de su segundo trasplante de corazón ortotópico.
- La presentación clínica incluyó fiebre recurrente, bacteriemia persistente, anemia y embolia arterial periférica.
- Las herramientas de diagnóstico incluyeron ecocardiografía transtoracica (ETT) y ecocardiografía transesofágica (ETE).
Principales resultados:
- TEE identificó una masa intraluminal en el sitio anastomático ascendente de la aorta.
- El paciente, que declinó la cirugía, respondió bien a un curso de 6 semanas de vancomicina.
- El seguimiento a los 34 meses no mostró infecciones recurrentes ni eventos embolicos.
Conclusiones:
- Destaca la importancia de evaluar el sitio anastomático ascendente de la aorta en pacientes con trasplante de corazón con bacteriemia.
- Hace hincapié en la importancia de considerar la IA incluso cuando la ecocardiografía de rutina no muestra afectación valvular o endocárdica.
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