儿童感染性内心炎由于杆菌疹:一个病例报告
Raúl Romero Feregrino1,2, Daniel O Pacheco Rosas2, María J Carlos De la Torre3
1Department of Pediatrics, Mexican Academy of Pediatrics, Mexico City, MEX.
Cureus
|October 15, 2025
概括
儿科感染性内心炎 (IE) 即使在健康的儿童中也可能是严重的. 通过MALDI-TOF识别的杆菌 (Streptococcus mitis) 在患有心脏缺陷的儿童中引起了IE,强调了早期诊断和潜在手术的必要性.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 传染性内心炎 (IE) 在儿童中很少见,特别是那些没有先天性心脏病的儿童.
- 杆菌,口腔开始性,是由于粘附和生物膜形成的侵入性IE的新兴原因.
- 精确识别S.mitis需要先进的技术,如MALDI-TOF MS由于其与S.pneumoniae的相似性.
研究的目的:
- 报告由S. mitis引起的儿科IE病例.
- 为了突出右侧内心炎的次要肺部干扰.
- 强调早期诊断和IE手术干预的重要性.
主要方法:
- 一个12岁的女性患有心室隔膜缺陷和IE的案例报告.
- 声心图用于检测心脏植被.
- 用于微生物识别的血液培养 (S. mitis).
- 马尔迪-托夫质谱仪用于准确的识别.
- 计算机断层扫描 (CT) 用于肺部评估.
- 门植被和VSD关闭的手术干预.
主要成果:
- S.mitis被确定为IE的致病原体.
- 患者出现了心脏植被,肺肺炎和败血栓塞.
- 进行了植被的手术切除和VSD关闭.
- 植被>10毫米与医疗反应不佳和较高的栓塞风险相关.
结论:
- 在儿科IE中,即使没有并发症,也应该考虑S. mitis.
- 肺部的干扰可以发生在右侧内心炎.
- 对持续发烧,阳性血液培养和非典型的肺部发现,即时的心声回声学至关重要.
- 早期诊断和治疗,包括必要时进行手术,可以改善结果.
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