原生主动脉内心炎是由肠道细菌转移引起的,其次是胃肠炎
Allison Molstad1,2, Alicia Latta1, Elizabeth Willis1
1Internal Medicine, Wright-Patterson Medical Center, Dayton, USA.
Cureus
|September 26, 2025
概括
一个罕见的传染性内心炎 (IE) 病例在原生大动脉中与胃肠炎有关,而不是典型的口腔细菌. 这突显了潜在的肠心细菌转移作为IE来源.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
背景情况:
- 原生膜感染性内心炎 (IE) 通常是由患有风险因素的患者的口腔细菌引起的.
- 冠状病毒群链球菌 (VGS) 是主动脉内心炎的常见原因,通常来自口腔植物.
- 在胃肠炎期间从肠道转移的细菌是IE的不常见来源.
研究的目的:
- 报告一种非典型的先天性大动脉内心炎病例.
- 在没有典型风险因素的患者中探索胃肠炎和IE之间的潜在联系.
- 为了突出一种不寻常的细菌血源,导致感染性内心炎.
主要方法:
- 一个64岁的女性出现急性症状的病例报告.
- 诊断工作,包括CT肺血管图像和心声回声图 (胸前和食道间).
- 血液培养物用于识别致病生物和随后的手术干预.
主要成果:
- 患者出现了模仿肺栓塞和感染性内心炎的症状.
- 心声扫描证实大动脉上有大量的植被.
- 血液培养物确定了*Streptococcus oralis/mitis*,导致了IE的诊断.
- 该患者成功地进行了大动脉门置换.
结论:
- 胃肠炎诱导的从肠道的细菌转移是一个合理的,尽管不常见的,本地门IE的来源.
- 这一案例强调了在IE中考虑非口腔细菌来源的重要性,特别是在异常呈现时.
- 患者的原生门IE,二次性胃肠炎没有传统的风险因素,代表了一个独特的临床情景.
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