晚期发作的假体内心炎,并有由Cutibacterium acnes引起的副大动脉
Ornela Velollari1,2, Christian Malte Reinhardt3, Maike Knorr1
1Department of Cardiology, Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany.
Infectious disease reports
|October 27, 2023
概括
菌 (Cutibacterium acnes) 是一种低毒性的细菌,可以引起严重的感染,如假体内心炎. 使用先进的成像和微生物学的早期诊断对于有效治疗和预防并发症至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 微生物学 微生物学
背景情况:
- 昆虫细菌 (C. acnes) 是一种常见的皮肤细菌,具有较低的毒性.
- 尽管毒性低,但C. acnes可以引起深层感染和医疗器械相关的感染.
研究的目的:
- 报告一个罕见的假肢内心炎和由C. acnes引起的腹病例.
- 突出诊断方面的挑战以及先进的成像和微生物学技术在确认C. acnes感染方面的实用性.
- 强调区分真实C. acnes感染与污染的重要性.
主要方法:
- 一个病例研究,一个患有假肢内心炎和准大动脉的患者.
- 最初的诊断涉及血液培养和标准心声回声学.
- 18F-FDG PET CT用于高级成像;PCR和16S rDNA测序用于微生物学确认.
主要成果:
- 鉴定出C. acnes是造成假肢内心炎和前列动脉瘤的原因,在最初的手术后5年出现.
- 最初的心声回声没有确定性,但18F-FDG PET CT显示了大动脉环周围显著的炎症.
- 先进的微生物学分析,包括膜组织的PCR和16SrDNA测序,最终确定了C. acnes.
结论:
- 由C. acnes引起的感染,特别是延迟发病的IE,需要高度的怀疑指数,因为它们有可能导致严重的并发症.
- 连续血液培养,长时间化,先进的微生物学分析和修改的杜克标准 (包括二线成像) 的组合对于准确的诊断至关重要.
- 这些感染不应被视为污染,因为它们的发病率和死亡率很高.
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