棒状杆菌引起感染性心内膜炎1例

A case of infective endocarditis caused by Corynebacterium

棒状杆菌(Corynebacteriu)广泛存在于水、土壤中,是人类口腔、鼻腔、外阴和皮肤的常居菌。从临床送检标本中分离出的棒状杆菌,通常被认为是污染。但现在越来越多文献报道其可引起严重的感染,如感染性心内膜炎(IE)、导管相关感染、假体关节感染等。棒状杆菌是IE的重要病原体,但目前由棒状杆菌引起的IE报告很少,治疗经验相对不足,且棒状杆菌的抗生素耐药性正在增加,使治疗更具有挑战性,需要更多的经验来进一步学习。本文描述1例以急性脑梗死为首发症状的老年男性患者,两次血培养结果经基质辅助激光解吸/电离飞行时间质谱(MALDI-TOF MS)鉴定为棒状杆菌,最终确诊为IE。

Corynebacterium exists widely in water and soil,and it is a resident bacterium in human oral cavity,nasal cavity,vulva and skin.Corynebacterium isolated from clinical specimens is usually considered as contamination.However,now more and more literatures report that it can cause serious infection,such as infective endocarditis(IE),catheter-related infection,prosthetic joint infection,etc.Corynebacterium is an important pathogen of IE,but at present,there are few reports of IE caused by Corynebacterium,and the treatment experience is relatively insufficient.Moreover,the antibiotic resistance of Corynebacterium is increasing,which makes the treatment more challenging and requires more experience for further study.A case of elderly man with acute cerebral infarction as the first symptom was described in this paper.The results of two blood cultures were identified as Corynebacterium by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS).Finally,he was diagnosed as infective endocarditis.