Haemophilus parainfluenzae Infective Endocarditis Confirmed by 16S rRNA Sequence Analysis from Culture Negative Tissue

Kyoung-Jin Park, Kyung Sun Park, Soo-Han Choi, Yae-Jean Kim, C. Ki, I. Kang, N. Lee
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引用次数: 2

Abstract

Blood culture-negative infective endocarditis (CNE) can be a diagnostic dilemma. Herein, we report a case of CNE caused by Haemophilus parainfluenzae identified only via 16S rRNA sequence analysis directly from valve tissue. A 17-year-old boy presented with high spiking fever for one month. Pansystolic murmur (Grade III) and vegetation (0.65×0.26 cm and 0.62×0.55 cm) on the anterior mitral valve leaflet via transesophageal echocardiogram suggested the diagnosis of infective endocarditis (IE). However, blood culture performed on admission was negative even after 2 weeks of incubation. Gram stain and culture of a direct tissue specimen failed to identify causative microorganism, while 16S rRNA gene sequences (548 bp) showed 100% identity with those of Haemophilus parainfluenzae (GenBank: FJ939586.1). The 16S rRNA sequence analysis with a direct tissue specimen might be useful in cases of CNE. (Korean J Clin Microbiol 2012;15:139-142)
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培养阴性组织16S rRNA序列分析证实副流感嗜血杆菌感染性心内膜炎
血培养阴性感染性心内膜炎(CNE)可能是一个诊断困境。在此,我们报告一例由副流感嗜血杆菌引起的CNE,仅通过16S rRNA序列分析直接从瓣膜组织中鉴定出来。一名17岁男童出现高热一个月。经食管超声心动图显示全收缩期杂音(III级)及二尖瓣前叶赘生物(0.65×0.26 cm和0.62×0.55 cm)提示感染性心内膜炎(IE)。然而,入院时进行的血培养即使在2周后也呈阴性。革兰氏染色和直接组织标本培养无法鉴定病原微生物,而16S rRNA基因序列(548 bp)与副流感嗜血杆菌(GenBank: FJ939586.1)的同源性为100%。直接组织标本的16S rRNA序列分析可能对CNE病例有用。(中华临床微生物杂志2012;15:139-142)
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