Aggregatibacter actinomycetemcomitans endocarditis in an adult patient with patent ductus arteriosus.

IF 1.7 Q3 INFECTIOUS DISEASES GERMS Pub Date : 2024-06-30 eCollection Date: 2024-06-01 DOI:10.18683/germs.2024.1433
Alina Maria Borcan, Mihaela Cristina Olariu, Elena Liliana Costea, Georgiana Radu, Mădălina Simoiu
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Abstract

Introduction: Aggregatibacter (Actinobacillus) actinomycetemcomitans is a commensal bacterial pathogen in the human oral cavity. It can, however, represent the source of local or systemic infections with serious evolution, in particular infective endocarditis. We present a particular case of an adult male patient with infective endocarditis with A. actinomycetemcomitans and patent ductus arteriosus (PDA).

Case report: A 37-year-old patient, chronic ethanol user, is hospitalized for altered general condition, persistent cough, left chest pain, headache and dizziness, symptoms evolving for about 3 weeks. The clinical examination revealed crackling pulmonary rales present basally bilaterally, as well as numerous cavities and dental abscesses. Chest radiography showed mixed left hiliobasal pneumonia. Chest CT depicted pulmonary abscess and two filling defects in the pulmonary artery trunk, possible thrombotic/vegetative images/mediastinal thrombotic/adenopathic images. Broad spectrum antibiotic treatment was initiated. Transthoracic ultrasonography visualized persistence of ductus arteriosus and an echodense formation attached to the lateral wall of the pulmonary artery trunk. Following positive blood cultures for Aggregatibacter actinomycetemcomitans, the diagnosis of infective endocarditis was established and antibiotic treatment was de-escalated to ceftriaxone according to the antibiogram. The clinical course under treatment was slowly favorable, the patient was discharged on request on day 44 with continued treatment at home.

Conclusions: Infective endocarditis caused by Aggregatibacter actinomycetemcomitans should be considered in patients with altered general condition and congenital cardiovascular defects. In the present case, the patient presented two risk factors, namely poor dental hygiene and PDA.

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一名患有动脉导管未闭的成年患者的放线菌聚集性心内膜炎。
介绍:放线杆菌(Aggregatibacter (Actinobacillus) actinomycetemcomitans)是人类口腔中的一种共生细菌病原体。然而,它也可能成为局部或全身感染的源头,并引起严重的演变,尤其是感染性心内膜炎。我们介绍了一例感染性心内膜炎的成年男性患者,他患有放线菌和动脉导管未闭(PDA):患者 37 岁,长期使用乙醇,因全身状况改变、持续咳嗽、左胸痛、头痛和头晕而住院,症状持续了约 3 周。临床检查发现,患者双侧肺部基底出现噼啪作响的啰音,并伴有大量龋齿和牙齿脓肿。胸片显示左侧髂基底混合性肺炎。胸部 CT 显示肺脓肿和肺动脉干的两个充盈缺损,可能存在血栓/植被影像/纵隔血栓/腺病影像。患者开始接受广谱抗生素治疗。经胸超声波检查发现动脉导管未闭,肺动脉干侧壁附着有回声斑。放线菌血液培养阳性后,感染性心内膜炎的诊断得以确立,抗生素治疗根据抗生素图谱升级为头孢曲松。在治疗过程中,患者的临床疗效缓慢好转,第 44 天应要求出院,并在家中继续接受治疗:结论:对于全身状况改变和先天性心血管缺陷的患者,应考虑放线菌引起的感染性心内膜炎。在本病例中,患者有两个危险因素,即牙齿卫生差和 PDA。
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来源期刊
GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
自引率
5.00%
发文量
36
期刊最新文献
Aggregatibacter actinomycetemcomitans endocarditis in an adult patient with patent ductus arteriosus. Clinical spectrum of extrapulmonary non-tuberculous mycobacterial disease in immunocompetent patients: a case series. Clinical, epidemiological and molecular aspects of patients with mpox in Romania. Continuous versus intermittent infusion of beta-lactam antibiotics: where do we stand today? A narrative review. Infective endocarditis by carbapenem-resistant Gram-negative bacteria - a systematic review.
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