血液培养-阴性军团菌 TAVR内心炎
E K Kronzer1, K O Barrett2, O Abu Saleh2
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
JACC. Case reports
|January 23, 2026
概括
本案例研究详细介绍了第一个血液培养阴性莱吉欧内拉心脏病假发内心炎 (PVE) 的实例. 先进的成像和分子诊断对于诊断这种罕见的军团菌感染至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 诊断微生物学 诊断微生物学
背景情况:
- 军团菌内心炎是一种罕见的疾病,带来了重大诊断挑战.
- 假内心炎 (PVE) 是心脏手术的一个严重并发症.
- 血培养阴性内心炎使诊断和治疗复杂化.
研究的目的:
- 报告第一个确诊的血液培养阴性Legionella cardiaca假内心炎 (PVE) 病例.
- 突出多模式成像和分子技术在复杂内心炎病例中的诊断实用性.
- 强调在培养负的PVE中考虑Legionella的重要性.
主要方法:
- 一名77岁的患者有过透导管大动脉置换病史,出现了长期症状,暗示着PVE.
- 采用多模式成像来评估假体门,揭示了显著的阻塞.
- 血微生物无细胞DNA测序和广泛的16SrRNA测序被用于病原体识别.
主要成果:
- 连续血液培养结果呈阴性,是培养阴性内心炎的特征.
- 血微生物无细胞DNA测序检测出了莱吉欧内拉菌种.
- 检测到的假的组织病理学证实了莱吉欧内拉细菌的存在,16SrRNA测序识别了L. cardiaca.
结论:
- 这一案例凸显了与培养负的Legionella PVE相关的诊断复杂性.
- 多模式成像对于诊断感染性内心炎,特别是PVE至关重要.
- 分子诊断方法对于早期和准确的血液培养负性内心炎的诊断是无价的,当传统方法失败时.
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