Insidious clinical presentation of uncommon infective endocarditis caused by Cardiobacterium species.

IF 1.5 4区 医学 Q4 MICROBIOLOGY
New Microbiologica Pub Date : 2025-05-01
Francesco Bassani, Gabriele Pagani, Marco Franzetti, Laura Pezzati, Luca Di Odoardo, Ilaria Lazzarini, Gennaro D'Anna, Serena Leva, Claudia Pavia, Paola Mirri, Stefano Rusconi
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Abstract

Infective endocarditis (IE) is a fatal disease caused by a wide range of pathogens, with a strong prevalence of Gram-positive bacteria. In this paper we describe two peculiar cases of Cardiobacterium spp. endocarditis in young men. These case reports emphasize the insidious clinical presentation of HACEK IE and lead to a brief review of the literature and discussion on this uncommon cause of infective endocarditis. One case is a man with a prior diagnosis of myxomatous mitral valve, presenting with neurological symptoms and a mycotic aneurysm of the right anterior cerebral artery. The second case was a man with no prior medical history, presenting with fever, lumbar and right-leg pain, which led to a diagnosis of atrial myxoma. The presence of congenital cardiac malformations and an insidious onset with early presentation but unusual or non-specific symptoms are evidenced with a high prevalence in this group of patients. The diagnostic workup including cultural examinations are analyzed in the discussion. We noticed, in accordance with recent literature, a time to positivity of blood cultures longer than for typical agents, but mostly inferior to 5 days. The majority of the reported cases went to surgery, while therapeutical regimens alternative to cephalosporins, especially quinolones, are recently gaining interest. While mortality rates are lower than those observed in other cases of IE, Cardiobacterium spp. IE is characterized by a high burden of complications, leading to an often-atypical presentation.

由心杆菌引起的罕见感染性心内膜炎的隐匿临床表现。
感染性心内膜炎(IE)是一种由多种病原体引起的致命疾病,以革兰氏阳性菌为主。在本文中,我们描述了两个特殊的情况下的心内膜炎的心杆菌在年轻男子。这些病例报告强调了HACEK IE的潜在临床表现,并导致对这种不常见的感染性心内膜炎的文献和讨论的简要回顾。一例男性二尖瓣黏液瘤,表现为神经系统症状和右脑前动脉真菌性动脉瘤。第二个病例是一名没有既往病史的男子,表现为发烧、腰椎和右腿疼痛,这导致了心房粘液瘤的诊断。先天性心脏畸形的存在和潜伏的起病,早期表现,但不寻常或非特异性症状,在这组患者中具有很高的患病率。讨论了包括文化检查在内的诊断检查。我们注意到,根据最近的文献,血培养阳性的时间比典型药物长,但大多低于5天。大多数报告的病例进行了手术治疗,而替代头孢菌素的治疗方案,特别是喹诺酮类药物,最近引起了人们的兴趣。虽然死亡率低于其他IE病例,但IE的特点是并发症负担高,导致通常是非典型的表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
New Microbiologica
New Microbiologica 生物-微生物学
CiteScore
2.20
自引率
5.60%
发文量
40
审稿时长
6-12 weeks
期刊介绍: The publication, diffusion and furtherance of research and study on all aspects of basic and clinical Microbiology and related fields are the chief aims of the journal.
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